Individual
GLENN ROBERT GROSELAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15531 E 127TH ST, LEMONT, IL 60439-8555
(630) 257-6350
Mailing address
15531 E 127TH ST, LEMONT, IL 60439-8555
(630) 257-6350
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019021314
IL
Other
Enumeration date
05/08/2008
Last updated
05/08/2008
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