Organization
GRANVILLE DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT DAWE D.D.S. (OWNER)
(815) 339-6888
Entity
Organization
Contact information
Practice address
100 N MCCOY ST, GRANVILLE, IL 61326-9329
(815) 339-6888
Mailing address
100 N MCCOY ST, GRANVILLE, IL 61326-9329
(815) 339-6888
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019016044
IL
Other
Enumeration date
02/04/2017
Last updated
02/04/2017
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