Organization
BOLINGBROOK DENTAL ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OSCAR G GONZALEZ (DIRECTOR OF OPERATIONS)
(219) 465-8627
Entity
Organization
Contact information
Practice address
391 QUADRANGLE DR, BOLINGBROOK, IL 60440-3442
(630) 759-4400
Mailing address
391 QUADRANGLE DR, BOLINGBROOK, IL 60440-3442
(630) 759-4400
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/22/2019
Last updated
01/22/2019
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