Healthcare Provider Details

I. General information

NPI: 1750051918
Provider Name (Legal Business Name): BARTLETT DENTISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2021
Last Update Date: 09/17/2021
Certification Date: 09/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 RAILROAD AVENUE
BARTLETT IL
60103
US

IV. Provider business mailing address

333 W. 1ST STREET
ELMHURST IL
60126
US

V. Phone/Fax

Practice location:
  • Phone: 630-830-6010
  • Fax: 630-830-6075
Mailing address:
  • Phone: 630-833-5110
  • Fax: 630-833-0458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: MRS. KRISTEN M. GALAYDA
Title or Position: SR. DIRECTOR BUSINESS OPERATION
Credential:
Phone: 630-833-5110