College Avenue Dental Sleep Appliances Ltd.
NPI #1962829366 in Jacksonville, Illinois
Provider Information
- NPI Number
- 1962829366
- Entity Type
- Organization
- Organization Name
- College Avenue Dental Sleep Appliances Ltd.
- Primary Specialty
- Durable Medical Equipment & Medical Supplies
- Enumeration Date
- Mar 24, 2014
- Last Updated
- Apr 22, 2014
Practice Location
- Address
- 505 W COLLEGE AVE
- City
- Jacksonville
- State
- Illinois
- ZIP Code
- 62650-2405
- Phone
- (217) 245-5313
Authorized Official
- Name
- RANDALL EVERT LAWSON, DDS
- Title
- OWNER
- Phone
- (217) 473-6758
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
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