Organization
G.R. CLEMENS, D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
G. R. CLEMENS D.D.S. (DENTIST)
(708) 795-1255
Entity
Organization
Contact information
Practice address
3340 OAK PARK AVE., SUITE 301, BERWYN, IL 60402-3483
(708) 795-1255
(708) 795-1215
Mailing address
3340 OAK PARK AVE., SUITE 301, BERWYN, IL 60402-3483
(708) 795-1255
(708) 795-1215
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19015658
IL
Other
Enumeration date
05/21/2012
Last updated
05/21/2012
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