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Organization

GRACELAND PRAIRIE DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSEPH P BARRY D.D.S. (OWNER)
(847) 824-3536
Entity
Organization

Contact information

Practice address
685 GRACELAND AVE, DES PLAINES, IL 60016-4518
(847) 824-3536
(847) 824-2783
Mailing address
685 GRACELAND AVE, DES PLAINES, IL 60016-4518
(847) 824-3536
(847) 824-2783

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019017115
IL
1223G0001X
General Practice Dentistry
019020748
IL

Other

Enumeration date
03/14/2012
Last updated
03/14/2012
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