Organization
GRAYSLAKE DENTAL CRARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FATEMEH AFSHAR DDS (PRESIDENT/OWNER)
(847) 223-2023
Entity
Organization
Contact information
Practice address
997 N CORPORATE CIR STE A, GRAYSLAKE, IL 60030-7822
(847) 223-2023
(847) 223-2012
Mailing address
997 N CORPORATE CIR STE A, GRAYSLAKE, IL 60030-7822
(847) 223-2023
(847) 223-2012
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/14/2019
Last updated
10/14/2019
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