Organization
SMILE LEE FACES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREA LACAYO DDS (PEDIATRIC DENTIST)
(773) 376-9999
Entity
Organization
Contact information
Practice address
4197 S ARCHER AVE, CHICAGO, IL 60632
(773) 376-9999
(773) 376-9990
Mailing address
4197 S ARCHER AVE, CHICAGO, IL 60632
(773) 376-9999
(773) 376-9990
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
019022928
IL
Other
Enumeration date
08/26/2009
Last updated
08/26/2009
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