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Organization
LAKE GENEVA DENTAL CARE, LLC
Active
Organization
LAKE GENEVA DENTAL CARE, LLC
Active
Other names
Beloit Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE GROH DDS (OWNER/PRESIDENT)
(630) 833-5110
Entity
Organization
Contact information
Practice address
1454 E HUEBBE PKWY, BELOIT, WI 53511-1714
(608) 362-0672
(608) 362-4960
Mailing address
333 W 1ST ST, ELMHURST, IL 60126-2641
(630) 833-5110
(630) 833-0458
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
019014858
IL
Other
Enumeration date
09/13/2013
Last updated
09/13/2013
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