# ELMHURST DENTAL GROUP, LTD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Addison Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073954723
- **Authorized official:** DR. LAWRENCE GROH DDS (OWNER/PRESIDENT)
- **Authorized official phone:** (630) 833-5110

## Contact information

- **Practice address:** 1201 W ARMY TRAIL BLVD, SUITE 2, ADDISON, IL 60101-3152
- **Practice address phone:** (630) 543-8688
- **Practice address fax:** (630) 543-8692
- **Mailing address:** 333 W 1ST ST, ELMHURST, IL 60126-2641
- **Mailing address phone:** (630) 833-5110
- **Mailing address fax:** (630) 833-0458

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 019014858 | IL | Yes |

## Other

- **Enumeration date:** 07/10/2013
- **Last updated:** 07/10/2013