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Organization
MY GERIATRIC DENTIST
Active
Organization
MY GERIATRIC DENTIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA BLUMOFE DDS (DENTIST)
(847) 590-1880
Entity
Organization
Contact information
Practice address
2093 RAND RD, DES PLAINES, IL 60016-4727
(847) 590-1880
(708) 590-0868
Mailing address
2093 RAND RD, DES PLAINES, IL 60016-4727
(847) 590-1880
(708) 590-0868
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/11/2020
Last updated
05/11/2020
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