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Organization
LIFETIME FAMILY DENTAL, P.C.
Active
Organization
LIFETIME FAMILY DENTAL, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTINA MOCKUNAS (OWNER)
(561) 713-7812
Entity
Organization
Contact information
Practice address
1890 SILVER CROSS BLVD STE 470, NEW LENOX, IL 60451-9528
(815) 717-8793
Mailing address
15309 S BUTTERCUP CT, PLAINFIELD, IL 60544-3156
(708) 263-3741
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/16/2023
Last updated
01/16/2023
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