Organization
OTRAGEN ORTHODONTICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDNA DOYLA (TREATMENT COORDINATOR)
(224) 223-8116
Entity
Organization
Contact information
Practice address
1500 SHERMER RD, SUITE #100, NORTHBROOK, IL 60062-5340
(224) 223-8116
Mailing address
1500 SHERMER RD, SUITE #100, NORTHBROOK, IL 60062-5340
(224) 223-8116
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
10/29/2008
Last updated
12/05/2013
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