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Organization
SMART DENTAL DESIGNERS
Active
Organization
SMART DENTAL DESIGNERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS GULLERMO LOPERA (GENERAL DENTIST)
(847) 672-4201
Entity
Organization
Contact information
Practice address
693 S LAKE ST, MUNDELEIN, IL 60060-3658
(847) 672-4201
(847) 672-4208
Mailing address
693 S LAKE ST, MUNDELEIN, IL 60060-3658
(847) 672-4201
(847) 672-4208
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019026862
IL
Other
Enumeration date
10/18/2010
Last updated
10/18/2010
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