Organization
LAKE GENEVA DENTAL CARE, LLC
Active
Other names
Milton Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE GROH DDS (OWNER/PRESIDENT)
(630) 833-5110
Entity
Organization
Contact information
Practice address
311 PARKVIEW DR, MILTON, WI 53563-1538
(608) 868-4462
(608) 868-9725
Mailing address
333 W 1ST ST, ELMHURST, IL 60126-2641
(630) 833-5110
(630) 833-0458
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019014858
IL
Other
Enumeration date
07/08/2014
Last updated
07/08/2014
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