| Lake Shore Dental Care | |
|
834 W Montrose Ave # 101 Chicago IL 60613-5813 | |
| (773) 989-9160 | |
| Not Available |
| Full Name | Lake Shore Dental Care |
|---|---|
| Speciality | Dentist |
| Location | 834 W Montrose Ave # 101, Chicago, Illinois |
| Authorized Official Name and Position | Ngoc-bich Thi Nguyen (PRESIDENT) |
| Authorized Official Contact | 7733695536 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Shore Dental Care 834 W Montrose Ave # 101 Chicago IL 60613-5813 Ph: (773) 989-9160 | Lake Shore Dental Care 834 W Montrose Ave # 101 Chicago IL 60613-5813 Ph: (773) 989-9160 |
| NPI Number | 1114226081 |
|---|---|
| Provider Enumeration Date | 03/17/2011 |
| Last Update Date | 03/17/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114226081 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019027633 (Illinois) | Primary |
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