Individual
BRADLEY S DEGROOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1S224 SUMMIT AVE, #205, OAKBROOK TERRACE, IL 60181-3983
(630) 627-3930
Mailing address
1S224 SUMMIT AVE, #205, OAKBROOK TERRACE, IL 60181-3983
(630) 627-3930
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019090200
IL
Other
Enumeration date
06/27/2012
Last updated
07/07/2015
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