Individual
DR. STEPHEN JOHN GRUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
6900 CERMAK RD, BERWYN, IL 60402-2244
(708) 484-7453
(708) 484-7574
Mailing address
6900 CERMAK RD, BERWYN, IL 60402-2244
(708) 484-7453
(708) 484-7574
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
21-001679
IL
Other
Enumeration date
03/13/2007
Last updated
07/08/2007
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