Organization
DENTAL ASSOCIATES OF ORLAND PARK, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARLEY BRAKER (PROVIDER CREDENTIALING TEAM LEADER)
(414) 808-3031
Entity
Organization
Contact information
Practice address
9443 W 144TH PL, ORLAND PARK, IL 60462-2543
(708) 403-9848
Mailing address
11711 W BURLEIGH ST, WAUWATOSA, WI 53222-3108
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/08/2019
Last updated
12/12/2023
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