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Organization

LONG GROVE DENTAL STUDIO

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. NICHOLE LEE DEMARS DDS (OWNER/DENTIST)
(847) 719-1973
Entity
Organization

Contact information

Practice address
3976 ROUTE 22, SUITE E, LONG GROVE, IL 60047
(847) 719-1973
(847) 719-1975
Mailing address
3976 ROUTE 22, SUITE E, LONG GROVE, IL 60047
(847) 719-1973
(847) 719-1975

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019025986
IL

Other

Enumeration date
03/31/2011
Last updated
03/31/2011
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