Individual
DR. AUSTIN LACKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3027 ENGLISH ROWS AVE STE 203, NAPERVILLE, IL 60564-5107
(630) 904-1106
Mailing address
1852 FREDERICKSBURG LN, AURORA, IL 60503-3647
(630) 200-9222
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019033069
IL
Other
Enumeration date
06/15/2021
Last updated
06/15/2021
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