Organization
ANDERSON FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH R. ANDERSON JR. D.D.S. (PRESIDENT)
(847) 295-0515
Entity
Organization
Contact information
Practice address
810 S. WAUKEGAN RD., SUITE 106, LAKE FOREST, IL 60045
(847) 295-0515
(847) 234-0048
Mailing address
810 S. WAUKEGAN RD., SUITE 106, LAKE FOREST, IL 60045
(847) 295-0515
(847) 234-0048
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
01919692
IL
Other
Enumeration date
09/03/2008
Last updated
09/03/2008
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