Organization
GRIFFIN ORTHODONTICS PC
Active
Organization
GRIFFIN ORTHODONTICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONCIEL GRIFFIN DDS (OWNER)
(773) 239-7696
Entity
Organization
Contact information
Practice address
10019 S WESTERN AVE, CHICAGO, IL 60643-1925
(773) 239-7696
Mailing address
10019 S WESTERN AVE, CHICAGO, IL 60643-1925
(773) 239-7696
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
IL
Other
Enumeration date
12/02/2013
Last updated
12/02/2013
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