| Image Dentistry | |
|
2450 Grass Lake Rd Suite C Lindenhurst IL 60046-5613 | |
| (847) 265-9022 | |
| (847) 265-9023 |
| Full Name | Image Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2450 Grass Lake Rd, Lindenhurst, Illinois |
| Authorized Official Name and Position | Jacy L Gaylord (MANAGER) |
| Authorized Official Contact | 8478045229 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Image Dentistry 830 W State Route 22 # 49 Lake Zurich IL 60047-2560 Ph: (847) 265-9022 | Image Dentistry 2450 Grass Lake Rd Suite C Lindenhurst IL 60046-5613 Ph: (847) 265-9022 |
| NPI Number | 1942754221 |
|---|---|
| Provider Enumeration Date | 08/04/2016 |
| Last Update Date | 08/04/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942754221 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019022864 (Illinois) | Primary |
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