| Great Lakes Dental | |
|
2246 E Grand Ave Lindenhurst IL 60046-7522 | |
| (847) 265-6444 | |
| (847) 264-6464 |
| Full Name | Great Lakes Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2246 E Grand Ave, Lindenhurst, Illinois |
| Authorized Official Name and Position | Raja Goel (BUSINESS OWNER) |
| Authorized Official Contact | 8472656444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Lakes Dental 2246 E Grand Ave Lindenhurst IL 60046-7522 Ph: (847) 265-6444 | Great Lakes Dental 2246 E Grand Ave Lindenhurst IL 60046-7522 Ph: (847) 265-6444 |
| NPI Number | 1295064541 |
|---|---|
| Provider Enumeration Date | 12/16/2009 |
| Last Update Date | 12/16/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295064541 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019025474 (Illinois) | Primary |
| 1223G0001X | Dentist - General Practice | 019025462 (Illinois) | Secondary |
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