Organization
LAKE ZURICH ORTHODONTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAM PHILIP CALABRESE DDS (ADMINISTRATOR)
(847) 847-7736
Entity
Organization
Contact information
Practice address
545 N. RAND RD., LAKE ZURICH, IL 60047-3134
(847) 847-7736
(866) 302-4168
Mailing address
545 N. RAND RD., LAKE ZURICH, IL 60047-3134
(847) 847-7736
(866) 302-4168
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
021.002483
IL
Other
Enumeration date
11/08/2012
Last updated
11/08/2012
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