Organization
GEORGETOWN DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHLEEN M HANSEN D.D.S. (SOLE MEMBER)
(630) 837-3700
Entity
Organization
Contact information
Practice address
7212 EDGEBROOK LN, HANOVER PARK, IL 60133-3751
(630) 837-3700
(630) 837-3849
Mailing address
7212 EDGEBROOK LANE, HANOVER PARK, IL 60133-3751
(630) 837-3700
(630) 837-3849
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019019366
IL
Other
Enumeration date
11/04/2009
Last updated
11/04/2009
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