Organization
GREGORY L. WEATHERS, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY LEE WEATHERS DDS (PRESIDENT)
(773) 775-2210
Entity
Organization
Contact information
Practice address
7760 W DEVON AVE, SUITE A, CHICAGO, IL 60631-1551
(773) 775-2210
(773) 775-2001
Mailing address
7760 W DEVON AVE, SUITE A, CHICAGO, IL 60631-1551
(773) 775-2210
(773) 775-2001
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19014704
IL
Other
Enumeration date
03/28/2008
Last updated
03/28/2008
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