Lake Family Dental

NPI #1639188295 in Glenview, Illinois

Provider Information

NPI Number: 1639188295
Entity Type: Organization
Organization Name: Lake Family Dental
Primary Specialty: Dentist - General Practice
Enumeration Date: Aug 5, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 1372 PATRIOT BLVD
City: Glenview
State: Illinois
ZIP Code: 60026-7777
Phone: (847) 998-9660

Authorized Official

Name: DR. PETER SUNG JONG CHANG, D.D.S.
Title: CO-OWNER
Phone: (847) 998-9660

Specialties & Taxonomy Codes

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

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