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General NPI Number Information
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NPI Number | 1871438077
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Entity Type | Organization
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Legal Business Name | GARRETT D. OBENAUF DMD PC
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Dates
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Enumeration Date | 04/22/2026
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Last Update Date | 04/22/2026
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Provider Practice Location Address
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Address Line | 205 COMMERCE DR STE A
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City | GRAYSLAKE
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State | IL
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Zip | 60030-1646
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Country | US
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Telephone | 224-381-6853
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Fax |
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Provider Business Mailing Address
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Address Line | 205 COMMERCE DR STE A
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City | GRAYSLAKE
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State | IL
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Zip | 60030-1646
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Country | US
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Telephone | 847-548-2020
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GARRETT DAVID OBENAUF
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Credential | DMD
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Telephone | 224-381-6853
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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