Individual
GARRETT DAVID OBENAUF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1109 W PARK AVE, LIBERTYVILLE, IL 60048-2552
(847) 367-1133
Mailing address
998 CASTLEWOOD CT, GURNEE, IL 60031-4106
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019032778
IL
Other
Enumeration date
07/08/2020
Last updated
07/08/2020
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