Organization
ELMHURST DENTAL GROUP, LTD DBA BLOOMINGDALE DENTAL
Active
Parent organization
ELMHURST DENTAL GROUP, LTD
Other names
Bloomingdale Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
ELMHURST DENTAL GROUP, LTD
Authorized official
DR. LAWRENCE P GROH (OWNER)
(630) 833-5110
Entity
Organization
Contact information
Practice address
290 SPRINGFIELD DR, SUITE 100, BLOOMINGDALE, IL 60108-2214
(630) 529-0027
(630) 529-0068
Mailing address
333 W 1ST ST, ELMHURST, IL 60126-2641
(630) 833-5110
(630) 833-0458
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
09/15/2009
Last updated
09/17/2009
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