Organization
GRACEFUL SMILES DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE MATHEW DDS (DENTIST)
(847) 414-3560
Entity
Organization
Contact information
Practice address
615 S RANDALL RD STE 110, SAINT CHARLES, IL 60174-1564
(847) 414-3560
Mailing address
3520 CHANCERY LN, CARPENTERSVILLE, IL 60110-3467
(847) 414-3560
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019.027466
IL
Other
Enumeration date
09/12/2017
Last updated
09/12/2017
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