Southwest Family Dental
Clinic/Center, Dental in New Lenox, IL. Organization (NPI-2).
NPI number1982186896
StatusActive
Last updated in NPPESSep 6, 2018
Details
- NPI
- 1982186896
- Entity type
- Organization (NPI-2)
- Legal business name
- Southwest Family Dental
- Organization subpart
- No
- Enumeration date
- Sep 6, 2018
- Last updated
- Sep 6, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | 019029805 | IL | Yes |
Practice location
165 S Marley RdNew Lenox, IL 60451-6045
Phone 815-485-3449
Mailing address
165 S Marley RdNew Lenox, IL 60451-3302
Phone 815-485-3449
Authorized official
Brendan D McGraw
Owner
8154853449
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Other Dental Clinic/Center providers in New Lenox, IL
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All 5 Dental Clinic/Center providers in New Lenox · All 1,012 providers in New Lenox
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