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Organization

LAKESIDE DENTAL CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHARLES ZELMORE TEICHER (PRESIDENT)
(312) 842-7133
Entity
Organization

Contact information

Practice address
2218 S MICHIGAN AVE, CHICAGO, IL 60616-2126
(312) 842-7133
(312) 842-7148
Mailing address
2218 S MICHIGAN AVE, CHICAGO, IL 60616-2126
(312) 842-7133
(312) 842-7148

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
IL

Other

Enumeration date
04/26/2007
Last updated
08/22/2020
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