| Graceland Prairie Dental | |
|
685 Graceland Ave Des Plaines IL 60016-4518 | |
| (847) 824-3536 | |
| (847) 824-2783 |
| Full Name | Graceland Prairie Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 685 Graceland Ave, Des Plaines, Illinois |
| Authorized Official Name and Position | Joseph P Barry (OWNER) |
| Authorized Official Contact | 8478243536 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Graceland Prairie Dental 685 Graceland Ave Des Plaines IL 60016-4518 Ph: (847) 824-3536 | Graceland Prairie Dental 685 Graceland Ave Des Plaines IL 60016-4518 Ph: (847) 824-3536 |
| NPI Number | 1134494727 |
|---|---|
| Provider Enumeration Date | 03/14/2012 |
| Last Update Date | 03/14/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134494727 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019017115 (Illinois) | Primary |
| 1223G0001X | Dentist - General Practice | 019020748 (Illinois) | Secondary |
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