| Lesage Dental Clinic Ltd | |
|
815 N Galena Ave Dixon IL 61021-1518 | |
| (815) 288-1418 | |
| Not Available |
| Full Name | Lesage Dental Clinic Ltd |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 815 N Galena Ave, Dixon, Illinois |
| Authorized Official Name and Position | Robert Thomas Lesage (DENTIST) |
| Authorized Official Contact | 8152881418 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lesage Dental Clinic Ltd 815 N Galena Ave Dixon IL 61021-1518 Ph: () - | Lesage Dental Clinic Ltd 815 N Galena Ave Dixon IL 61021-1518 Ph: (815) 288-1418 |
| NPI Number | 1528085271 |
|---|---|
| Provider Enumeration Date | 07/17/2006 |
| Last Update Date | 10/22/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528085271 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 19A13394 (Illinois) | Primary |
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