Provider Demographics
NPI:1376992560
Name:GRAND DENTAL ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:GRAND DENTAL ASSOCIATES, P.C.
Other - Org Name:GRAND DENTAL - WILMINGTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:NAPIER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:815-476-6755
Mailing Address - Street 1:1780 N FARNSWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60505-1576
Mailing Address - Country:US
Mailing Address - Phone:630-585-9333
Mailing Address - Fax:630-585-9950
Practice Address - Street 1:101 FULTON ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:IL
Practice Address - Zip Code:60481-1694
Practice Address - Country:US
Practice Address - Phone:815-476-6755
Practice Address - Fax:815-476-7590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-08
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty