Organization
DENEMARK PERIODONTAL SPECIALISTS, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL JOHN DENEMARK DDS, MSD (PRESIDENT/OWNER)
(630) 654-4141
Entity
Organization
Contact information
Practice address
570 VILLAGE CENTER DR, SUITE 202B, BURR RIDGE, IL 60527-4520
(630) 654-4141
(630) 654-4242
Mailing address
570 VILLAGE CENTER DR, SUITE 202B, BURR RIDGE, IL 60527-4520
(630) 654-4141
(630) 654-4242
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
0109022926
IL
Other
Enumeration date
01/03/2009
Last updated
11/29/2010
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