Organization
GLEN ELLYN ORTHODONTIC ASSOCIATES, P.C.
Active
Organization
GLEN ELLYN ORTHODONTIC ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS ROBERT PRINCE DDS,MS,PC (OWNER)
(630) 469-5225
Entity
Organization
Contact information
Practice address
507 DUANE ST, GLEN ELLYN, IL 60137-4549
(630) 469-5225
(630) 469-5443
Mailing address
507 DUANE ST, GLEN ELLYN, IL 60137-4549
(630) 469-5225
(630) 469-5443
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
019-014235
IL
Other
Enumeration date
05/23/2007
Last updated
01/08/2009
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