Organization
PRAIRIE ORTHODONTICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRIDGET O MUELLER (OFFICE MANAGER)
(847) 249-8800
Entity
Organization
Contact information
Practice address
6121 WASHINGTON ST, SUITE 204, GURNEE, IL 60031
(847) 249-8800
(847) 249-8869
Mailing address
6121 WASHINGTON ST, SUITE 204, GURNEE, IL 60031
(847) 249-8800
(847) 249-8869
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
06006486
IL
Other
Enumeration date
11/21/2006
Last updated
08/22/2020
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