Individual
CLAY GORDON VANDERWALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
406 W BOUGHTON RD, SUITE B, BOLINGBROOK, IL 60440-1340
(630) 759-8940
(630) 759-9392
Mailing address
406 W BOUGHTON RD, SUITE B, BOLINGBROOK, IL 60440-1340
(630) 759-8940
(630) 759-9392
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
IL
Other
Enumeration date
08/15/2007
Last updated
08/15/2007
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