Lake Forest Pediatic Dentistry, PC

NPI #1841608502 in Lake Forest, Illinois

Provider Information

NPI Number
1841608502
Entity Type
Organization
Organization Name
Lake Forest Pediatic Dentistry, PC
Primary Specialty
Clinic/Center - Dental
Enumeration Date
Jul 25, 2014
Last Updated
Jul 25, 2014

Practice Location

Address
500 N WESTERN AVE
Address 2
SUITE 215
ZIP Code
60045-1954
Phone
(847) 482-1900

Authorized Official

Name
JOSEPH GORDON, D.D.S.
Title
PEDIATRIC DENTIST, PRESIDENT
Phone
(847) 482-1900

Specialties & Taxonomy Codes

Specialty
Clinic/Center - DentalDental

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