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Organization
NORTHSHORE METROPOLITAN DENTAL ASSOCIATES INC
Active
Organization
NORTHSHORE METROPOLITAN DENTAL ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR KA-TAI LAU D.D.S. (PRESIDENT)
(847) 673-6770
Entity
Organization
Contact information
Practice address
1790 NATIONS DR, SUITE 212, GURNEE, IL 60031-9164
(847) 336-4880
Mailing address
1790 NATIONS DR, SUITE 212, GURNEE, IL 60031-9164
(847) 336-4880
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019025154
IL
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
03/01/2007
Last updated
08/26/2019
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