Organization
ELK GROVE DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
A. KHAN (STAFF)
(847) 895-0000
Entity
Organization
Contact information
Practice address
1121 NERGE RD, ELK GROVE VILLAGE, IL 60007-3260
(847) 895-0000
Mailing address
1121 NERGE RD, ELK GROVE VILLAGE, IL 60007-3260
(847) 895-0000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019.024689
IL
122300000X
Dentist
Primary
019.025459
IL
Other
Enumeration date
01/09/2016
Last updated
02/18/2016
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