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Organization
ORLAND SQUARE DENTAL
Active
Organization
ORLAND SQUARE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GADIA PEABODY (GENERAL DENTIST)
(708) 460-7440
Entity
Organization
Contact information
Practice address
62 ORLAND SQUARE DR STE 104, ORLAND PARK, IL 60462-6558
(708) 460-7440
Mailing address
62 ORLAND SQUARE DR STE 104, ORLAND PARK, IL 60462-6558
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019-026130
IL
Other
Enumeration date
10/19/2009
Last updated
10/19/2009
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