Lagrange Periodontics, Ltd

NPI #1023175775 in Countryside, Illinois

Provider Information

NPI Number: 1023175775
Entity Type: Organization
Organization Name: Lagrange Periodontics, Ltd
Primary Specialty: Dentist - Periodontics
Enumeration Date: Jan 2, 2007
Last Updated: Oct 30, 2019

Practice Location

Address: 6520 JOLIET RD
City: Countryside
State: Illinois
ZIP Code: 60525
Phone: (708) 354-4545

Authorized Official

Name: DR. MICHELLE P JENNINGS, DDS
Title: PRESIDENT/PERIODONTIST
Phone: (708) 354-4545

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Periodontics — Periodontics	1223P0300X	Primary

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DR. Michelle P Jennings, DDS	Dentist - Periodontics	Countryside	AI Deep Dive
DR. Eugene J Buksa, DDS, MS	Dentist - Periodontics	Countryside	AI Deep Dive
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Lagrange Perio LLC	Dentist - Periodontics	Countryside	AI Deep Dive

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