Healthcare Provider Details

I. General information

NPI: 1639203912
Provider Name (Legal Business Name): GRAND DENTAL ASSOCIATES P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 06/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10020 GRAND AVE
FRANKLIN PARK IL
60131-2547
US

IV. Provider business mailing address

1780 N FARNSWORTH AVE
AURORA IL
60505-1576
US

V. Phone/Fax

Practice location:
  • Phone: 847-455-8383
  • Fax: 847-455-1265
Mailing address:
  • Phone: 630-585-9333
  • Fax: 630-585-9950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. STEVE NAPIER
Title or Position: PARTNER
Credential: DDS
Phone: 847-455-8383