Lanark Dental Clinic, P.c.

NPI #1609995885 in Lanark, Illinois

Provider Information

NPI Number: 1609995885
Entity Type: Organization
Organization Name: Lanark Dental Clinic, P.c.
Primary Specialty: Dentist - General Practice
Enumeration Date: Mar 28, 2007
Last Updated: Dec 20, 2007

Practice Location

Address: 120 S BROAD ST
City: Lanark
State: Illinois
ZIP Code: 61046-1204
Phone: (815) 493-2244

Authorized Official

Name: DENNIS WALTERS
Title: PRESIDENT
Phone: (815) 493-2244

Specialties & Taxonomy Codes

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

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