Lake Forest Dental Associates, Pc | |
133 E Laurel Ave Lake Forest IL 60045-1205 | |
(847) 234-6440 | |
(847) 234-2195 |
Full Name | Lake Forest Dental Associates, Pc |
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Speciality | Dentist - Prosthodontics |
Location | 133 E Laurel Ave, Lake Forest, Illinois |
Authorized Official Name and Position | Richard D. Cottrell (OWNER) |
Authorized Official Contact | 8472346440 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Lake Forest Dental Associates, Pc 133 E Laurel Ave Lake Forest IL 60045-1205 Ph: (847) 234-6440 | Lake Forest Dental Associates, Pc 133 E Laurel Ave Lake Forest IL 60045-1205 Ph: (847) 234-6440 |
NPI Number | 1396991196 |
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Provider Enumeration Date | 08/12/2008 |
Last Update Date | 08/12/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396991196 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0700X | Dentist - Prosthodontics | 019.014822 (Illinois) | Primary |
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