# GENTLECARE FOR KIDS TEETH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982754123
- **Authorized official:** DR. BAMINI BLAU DDS (PEDIATRIC DENTIST)
- **Authorized official phone:** (630) 213-3636

## Contact information

- **Practice address:** 774 W BARTLETT RD, BARTLETT, IL 60103
- **Practice address phone:** (630) 213-3636
- **Mailing address:** 650 MILL CIR, UNIT 305, WHEELING, IL 60090-4208
- **Mailing address phone:** (630) 213-3636

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | IL | Yes |

## Other

- **Enumeration date:** 01/11/2007
- **Last updated:** 08/22/2020