| Lanark Dental Clinic | |
|
120 S Broad St Lanark IL 61046-1204 | |
| (815) 493-2244 | |
| (815) 493-2922 |
| Full Name | Lanark Dental Clinic |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 120 S Broad St, Lanark, Illinois |
| Authorized Official Name and Position | Dennis Walters (PRESIDENT) |
| Authorized Official Contact | 8154932244 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lanark Dental Clinic 120 S Broad St P.o. Box 43 Lanark IL 61046-1204 Ph: (815) 493-2244 | Lanark Dental Clinic 120 S Broad St Lanark IL 61046-1204 Ph: (815) 493-2244 |
| NPI Number | 1609995885 |
|---|---|
| Provider Enumeration Date | 03/28/2007 |
| Last Update Date | 12/20/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609995885 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Illinois) | Primary |