Lagrange Dental Management
NPI #1013151901 in La Grange Park, Illinois
Provider Information
- NPI Number
- 1013151901
- Entity Type
- Organization
- Organization Name
- Lagrange Dental Management
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Apr 23, 2009
- Last Updated
- Apr 23, 2009
Practice Location
- Address
- 342 SHERWOOD RD
- City
- La Grange Park
- State
- Illinois
- ZIP Code
- 60526-1967
- Phone
- (708) 482-4610
Authorized Official
- Name
- MR. JONATHAN VILLANUEVA
- Title
- PRACTICE MANAGER
- Phone
- (630) 324-6749
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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