Organization
GLENLAKE DENTAL CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY AFZALI DDS (PRESIDENT)
(847) 724-3969
Entity
Organization
Contact information
Practice address
946 HARLEM AVE, GLENVIEW, IL 60025-4275
(847) 724-3969
Mailing address
946 HARLEM AVE, GLENVIEW, IL 60025-4275
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223P0300X
Periodontics
—
—
124Q00000X
Dental Hygienist
—
—
Other
Enumeration date
03/27/2012
Last updated
03/27/2012
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