| Lisa Grant Orthodontics | |
|
18243 Harwood Ave Homewood IL 60430-2149 | |
| (708) 799-3030 | |
| Not Available |
| Full Name | Lisa Grant Orthodontics |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 18243 Harwood Ave, Homewood, Illinois |
| Authorized Official Name and Position | Lisa Hope Grant (DOCTOR/OWNER) |
| Authorized Official Contact | 7087003030 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Grant Orthodontics 18243 Harwood Ave Homewood IL 60430-2149 Ph: (708) 799-3030 | Lisa Grant Orthodontics 18243 Harwood Ave Homewood IL 60430-2149 Ph: (708) 799-3030 |
| NPI Number | 1225472749 |
|---|---|
| Provider Enumeration Date | 04/26/2013 |
| Last Update Date | 04/26/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225472749 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 021001652 (Illinois) | Primary |
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