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Organization

GREENLEAF ORTHODONTICS - PARK CITY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRIAN PATRICK LABLONDE DDS (OWNER)
(317) 965-0810
Entity
Organization

Contact information

Practice address
355 GREENLEAF ST STE D, PARK CITY, IL 60085-5708
(262) 758-6038
(888) 475-7136
Mailing address
355 GREENLEAF ST STE D, PARK CITY, IL 60085-5708
(262) 758-6038
(888) 475-7136

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary

Other

Enumeration date
09/29/2025
Last updated
10/06/2025
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