Organization
BERNARDI & GROESCH DDS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES WILLIAM GROESCH DDS (PRESIDENT)
(217) 546-4674
Entity
Organization
Contact information
Practice address
2534 FARRAGUT DRIVE, SPRINGFIELD, IL 62704
(217) 546-4674
(217) 546-4659
Mailing address
2534 FARRAGUT DRIVE, SPRINGFIELD, IL 62704
(217) 546-4674
(217) 546-4659
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
IL
Other
Enumeration date
11/01/2006
Last updated
08/22/2020
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