Lakeside Dental Center

NPI #1063820694 in Chicago, Illinois

Provider Information

NPI Number: 1063820694
Entity Type: Organization
Organization Name: Lakeside Dental Center
Primary Specialty: Dentist
Enumeration Date: Jul 28, 2014
Last Updated: Jul 28, 2014

Practice Location

Address: 4945 W GRAND AVE
City: Chicago
State: Illinois
ZIP Code: 60639-4412
Phone: (224) 366-0498

Authorized Official

Name: HUSSAIN ALI, DDS
Title: OWNER
Phone: (224) 366-0498

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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