Organization
LAWRENCE PLAZA DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN J ACIERNO DDS (MANAGER)
(630) 339-3172
Entity
Organization
Contact information
Practice address
129 S ROSELLE RD, SUITE 102, SCHAUMBURG, IL 60193-5540
(630) 339-3172
(847) 339-3172
Mailing address
5912 W LAWRENCE AVE, CHICAGO, IL 60630-3305
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
019016834
IL
305R00000X
Preferred Provider Organization
019018205
IL
305R00000X
Preferred Provider Organization
019027347
IL
305R00000X
Preferred Provider Organization
Primary
01905148
IL
Other
Enumeration date
02/12/2015
Last updated
02/12/2015
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