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Individual

DR. GLENN WILLIAM BREDFELDT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
820 S DAMEN AVE, JESSE BROWN VAMC DENTAL SERVICE, CHICAGO, IL 60612-3728
(312) 569-6669
Mailing address
0N620 HERRICK DR, WHEATON, IL 60187-3088
(630) 668-6514

Taxonomy

Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
19-014804
IL

Other

Enumeration date
08/18/2006
Last updated
07/08/2007
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