Provider Demographics
NPI:1073731535
Name:ROBERT F. BRANDYS DDS, MSD, LTD.
Entity Type:Organization
Organization Name:ROBERT F. BRANDYS DDS, MSD, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:BRANDYS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:630-469-1500
Mailing Address - Street 1:45 S PARK BLVD
Mailing Address - Street 2:SUITE 225
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-6280
Mailing Address - Country:US
Mailing Address - Phone:630-469-1500
Mailing Address - Fax:630-469-8533
Practice Address - Street 1:45 S PARK BLVD
Practice Address - Street 2:SUITE 225
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-6280
Practice Address - Country:US
Practice Address - Phone:630-469-1500
Practice Address - Fax:630-469-8533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty