Lakeside Dental Center

NPI #1104046671 in Chicago, Illinois

Provider Information

NPI Number: 1104046671
Entity Type: Organization
Organization Name: Lakeside Dental Center
Primary Specialty: Dentist - General Practice
Enumeration Date: Apr 26, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 2218 S MICHIGAN AVE
City: Chicago
State: Illinois
ZIP Code: 60616-2126
Phone: (312) 842-7133

Authorized Official

Name: DR. CHARLES ZELMORE TEICHER
Title: PRESIDENT
Phone: (312) 842-7133

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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