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Organization

LARY M. PANE, D.D.S.,P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LARY M PANE D.D.S.,P.C. (PRESIDENT)
(708) 547-7160
Entity
Organization

Contact information

Practice address
4420 SAINT CHARLES RD, BELLWOOD, IL 60104-1157
(708) 547-7160
(630) 426-0211
Mailing address
4420 SAINT CHARLES RD, BELLWOOD, IL 60104-1157
(708) 547-7160
(630) 426-0211

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
01901546
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1005522
IL
Enumeration date
04/18/2008
Last updated
04/18/2008
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