Individual provider · Type 1 NPI

Clay Gordon Vanderwall, DDS

Orthodontics and Dentofacial Orthopedics Dentistry · Bolingbrook, IL

NPI number 1962694737 Active

Practice location

406 W Boughton Rd, Suite B
Bolingbrook, IL 60440-1340

Fax (630) 759-9392

Specialties and licenses

TaxonomyCodeLicense
Orthodontics and Dentofacial Orthopedics Dentistry Primary 1223X0400XNone listed

Orthodontics and Dentofacial Orthopedics Dentistry: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of funct…

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About NPI 1962694737

Clay Gordon Vanderwall, DDS's National Provider Identifier is 1962694737, issued on Aug 15, 2007. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in Bolingbrook, IL. The record was last updated on Aug 15, 2007.