| Hidden Lakes Dental Care, P.c. | |
|
680 W Boughton Rd Bolingbrook IL 60440-2185 | |
| (630) 759-0077 | |
| (630) 759-0082 |
| Full Name | Hidden Lakes Dental Care, P.c. |
|---|---|
| Speciality | Dentist |
| Location | 680 W Boughton Rd, Bolingbrook, Illinois |
| Authorized Official Name and Position | Charles E Crowl (PRESIDENT) |
| Authorized Official Contact | 6307590077 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hidden Lakes Dental Care, P.c. 680 W Boughton Rd Bolingbrook IL 60440-2185 Ph: (630) 759-0077 | Hidden Lakes Dental Care, P.c. 680 W Boughton Rd Bolingbrook IL 60440-2185 Ph: (630) 759-0077 |
| NPI Number | 1649378571 |
|---|---|
| Provider Enumeration Date | 09/21/2006 |
| Last Update Date | 04/29/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649378571 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 060-007659 (Illinois) | Primary |
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