Bradley S Degroot DDS

NPI 1215291901 - Student in an Organized Health Care Education/Training Program - 390200000X

NPI Details
NPI 1215291901
Gender Male
Enumeration Date 06/27/2012
Last Updated 07/07/2015
Entity Type Individual
Active Over 4 years ago
Practice Location
1S224 SUMMIT AVE
#205
OAKBROOK TERRACE IL, 60181-3983, US
Phone (630) 627-3930
Fax
Business Location
1S224 SUMMIT AVE
#205
OAKBROOK TERRACE IL, 60181-3983, US
Phone (630) 627-3930
Fax
Toxanomy
Taxonomy Code 390200000X
License State
License Number
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According to our database, Bradley S Degroot DDS NPI is 1215291901, taxonomy code is 390200000X Bradley S Degroot DDS physically located at 1s224 Summit Ave, Oakbrook Terrace IL, 60181-3983. NPI Number Bradley S Degroot DDS has the Individual type.

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1215291901 NPI number is provided on an as is basis without warranty of any kind. 1215291901 is maintained by the National Plan & Provider Enumeration System. The contents of Bradley S Degroot DDS are for informational purposes only.