| Farmington Lakes Dental | |
|
1241 Farmington Lakes Dr Oswego IL 60543-5109 | |
| (331) 212-5085 | |
| Not Available |
| Full Name | Farmington Lakes Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1241 Farmington Lakes Dr, Oswego, Illinois |
| Authorized Official Name and Position | Kabil Chunprapaph (PRESIDENT) |
| Authorized Official Contact | 3312125085 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Farmington Lakes Dental 1241 Farmington Lakes Dr Oswego IL 60543-5109 Ph: (331) 212-5085 | Farmington Lakes Dental 1241 Farmington Lakes Dr Oswego IL 60543-5109 Ph: (331) 212-5085 |
| NPI Number | 1437403029 |
|---|---|
| Provider Enumeration Date | 11/03/2012 |
| Last Update Date | 11/03/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437403029 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 019025947 (Illinois) | Primary |
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