Organization
ORLAND SQUARE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY WOLTER (INSURANCE MANAGER)
(630) 869-5857
Entity
Organization
Contact information
Practice address
62 ORLAND SQUARE DR STE 304, ORLAND PARK, IL 60462-6560
(708) 349-1919
Mailing address
62 ORLAND SQUARE DR STE 304, ORLAND PARK, IL 60462-6560
(708) 349-1919
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019018843
IL
Other
Enumeration date
02/12/2018
Last updated
02/12/2018
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