Organization
LAKELAND HILLS DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER J. JANKOWSKI (PRESIDENT/DENTIST)
(618) 222-1942
Entity
Organization
Contact information
Practice address
5011 N ILLINOIS, SUITE 1, FAIRVIEW HEIGHTS, IL 62208-3419
(618) 222-1942
Mailing address
256 ARBOR MEADOWS COURT, FAIRVIEW HEIGHTS, IL 62208-3419
(618) 444-4665
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1318983
UCCI
IL
Enumeration date
08/08/2006
Last updated
08/22/2020
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