Organization
PETTY & DRAGSTREM ORTHODONTICS, LLC
Active
Organization
PETTY & DRAGSTREM ORTHODONTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA DRAGSTREM (OWNER)
(708) 246-4000
Entity
Organization
Contact information
Practice address
5455 WOLF RD, WESTERN SPRINGS, IL 60558-1853
(708) 246-4000
Mailing address
5455 WOLF RD, WESTERN SPRINGS, IL 60558-1853
(708) 246-4000
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
248001868
IL
Other
Enumeration date
10/05/2017
Last updated
03/17/2018
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