Organization
DE LOS REYES DENTAL LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMELIA A. DE LOS REYES (OFFICE MANAGER)
(847) 699-2358
Entity
Organization
Contact information
Practice address
300 N. MILWAUKEE AVENUE, STE. A, LAKE VILLA, IL 60046
(847) 699-2358
(847) 265-0744
Mailing address
P.O. BOX 188, LAKE VILLA, IL 60046
(847) 699-2358
(847) 265-0744
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019-021017
IL
Other
Enumeration date
08/24/2009
Last updated
08/24/2009
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