Organization
FAIRVIEW DENTAL CARE GROUP P.C.
Active
Parent organization
GREAT LAKES DENTAL PARTNERS LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GREAT LAKES DENTAL PARTNERS LLC
Authorized official
MR. ROSHAN PARIKH D.D.S. (PRESIDENT/CEO)
(630) 852-5353
Entity
Organization
Contact information
Practice address
6317 FAIRVIEW AVE, SUITE 6, WESTMONT, IL 60559-2887
(630) 852-5353
(630) 968-0958
Mailing address
6317 FAIRVIEW AVE, SUITE 6, WESTMONT, IL 60559-2887
(630) 852-5353
(630) 968-0958
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/14/2016
Last updated
01/14/2016
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