Organization
GLEN ELLYN ORTHODONTICS, PC
Active
Other names
Wardell Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE S. WARDELL DMD (PRESIDENT)
(630) 697-0334
Entity
Organization
Contact information
Practice address
45 S PARK BLVD, SUITE 220, GLEN ELLYN, IL 60137-6280
(630) 469-6200
(630) 469-6203
Mailing address
45 S PARK BLVD, SUITE 220, GLEN ELLYN, IL 60137-6280
(630) 469-6200
(630) 469-6203
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
021.002325
IL
Other
Enumeration date
11/16/2016
Last updated
11/16/2016
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