Organization
GREGORY L. FAUTH, D.D.S.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY L. FAUTH D.D.S. (PRESIDENT)
(630) 896-2900
Entity
Organization
Contact information
Practice address
1940 W GALENA BLVD, SUITE 4, AURORA, IL 60506-4319
(630) 896-2900
(630) 896-2968
Mailing address
1940 W GALENA BLVD, SUITE 4, AURORA, IL 60506-4319
(630) 896-2900
(630) 896-2968
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
211159
IL
Other
Enumeration date
08/31/2006
Last updated
06/04/2012
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