| Lakeside Dentistry | |
|
820 Davis St Ste 460 Evanston IL 60201-4431 | |
| (847) 332-2226 | |
| (847) 332-1683 |
| Full Name | Lakeside Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 820 Davis St, Evanston, Illinois |
| Authorized Official Name and Position | Robert G. Brunetti (C.E.O.) |
| Authorized Official Contact | 8476401112 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeside Dentistry 605 E Algonquin Rd Ste 300 Arlington Heights IL 60005-4373 Ph: (847) 640-1112 | Lakeside Dentistry 820 Davis St Ste 460 Evanston IL 60201-4431 Ph: (847) 332-2226 |
| NPI Number | 1841357084 |
|---|---|
| Provider Enumeration Date | 01/03/2007 |
| Last Update Date | 06/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841357084 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 060-008822 (Illinois) | Primary |
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