Organization
ELITE FAMILY DENTAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOUIS WHITESMAN DDS, MS (PRESIDENT)
(734) 709-1363
Entity
Organization
Contact information
Practice address
719 BARRON BLVD, GRAYSLAKE, IL 60030-3314
(734) 709-1363
Mailing address
719 BARRON BLVD, GRAYSLAKE, IL 60030-3314
(734) 709-1363
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019026746
IL
Other
Enumeration date
11/15/2013
Last updated
11/15/2013
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