Organization
LISA GRANT ORTHODONTICS
Active
Organization
LISA GRANT ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA HOPE GRANT D.D.S. M.S (DOCTOR/OWNER)
(708) 700-3030
Entity
Organization
Contact information
Practice address
18243 HARWOOD AVE, HOMEWOOD, IL 60430-2149
(708) 799-3030
Mailing address
18243 HARWOOD AVE, HOMEWOOD, IL 60430-2149
(708) 799-3030
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
021001652
IL
Other
Enumeration date
04/26/2013
Last updated
04/26/2013
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