| Lakeshore Dental, Inc. | |
|
630 Vernon Ave Suite C Glencoe IL 60022-1681 | |
| (847) 835-1450 | |
| (847) 835-0628 |
| Full Name | Lakeshore Dental, Inc. |
|---|---|
| Speciality | Dentist |
| Location | 630 Vernon Ave, Glencoe, Illinois |
| Authorized Official Name and Position | Michael Bobrow (OWNER) |
| Authorized Official Contact | 8478351450 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeshore Dental, Inc. 630 Vernon Ave Suite C Glencoe IL 60022-1681 Ph: (847) 835-1450 | Lakeshore Dental, Inc. 630 Vernon Ave Suite C Glencoe IL 60022-1681 Ph: (847) 835-1450 |
| NPI Number | 1346540119 |
|---|---|
| Provider Enumeration Date | 10/27/2010 |
| Last Update Date | 10/27/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346540119 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019020613 (Illinois) | Primary |
Savin Dental Associates Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 650 Vernon Ave, Glencoe, IL 60022 Phone: 847-835-3200 Fax: 847-835-0905 |