Individual
DR. DOUGLAS W HEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.S.
Contact information
Practice address
420 PENNSYLVANIA AVE, GLEN ELLYN, IL 60137-4437
(630) 858-2060
(630) 858-4025
Mailing address
420 PENNSYLVANIA AVE, GLEN ELLYN, IL 60137-4437
(630) 858-2060
(630) 858-4025
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
IL
Other
Enumeration date
11/09/2006
Last updated
07/08/2007
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