Fairfield Dental

NPI #1629347497 in Round Lake, Illinois

Provider Information

NPI Number: 1629347497
Entity Type: Organization
Organization Name: Fairfield Dental
Subpart: Yes (part of a larger organization)
Parent Organization: LAWRENCE DENTAL GROUP, P.C.
Primary Specialty: Dentist
Enumeration Date: Dec 22, 2011
Last Updated: Dec 22, 2011

Practice Location

Address: 732 N FAIRFIELD RD
City: Round Lake
State: Illinois
ZIP Code: 60073-8160
Phone: (847) 740-4100

Authorized Official

Name: DR. GEORGE KOROVILAS, D.D.S.
Title: PRESIDENT
Phone: (773) 740-4100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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