Widen, Krystle Grandberry

Widen, Krystle Grandberry is an individual health care provider with primary practice located at 1113 Chicago Ave , Oak Park IL 60302-1803. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Widen, Krystle Grandberry can be contacted via phone (708) 383-0500.

Contact Information

Primary practice address
1113 Chicago Ave Oak Park IL 60302-1803
Phone: (708) 383-0500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 019.033543 Illinois

Profile Details

NPI number 1063942159
LBN Legal business name Widen, Krystle Grandberry
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2017
Last updated Feb 16th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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