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Individual

DR. DONALD LEE BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
439 LAKE ST, ANTIOCH, IL 60002-1405
(847) 395-3250
Mailing address
1200 NEUWAY LN, ANTIOCH, IL 60002-6236
(312) 375-9673

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019019360
IL
1223G0001X
General Practice Dentistry
2901018542
MI

Other

Enumeration date
03/05/2007
Last updated
08/08/2025
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