Organization
APEX-NORTHWESTERN DENTAL GROUP LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE A MULVANEY DDS (MANAGING PARTNER)
(815) 398-0303
Entity
Organization
Contact information
Practice address
364 FINANCIAL CT, SUITE A, ROCKFORD, IL 61107-6668
(815) 398-0303
Mailing address
364 FINANCIAL CT, SUITE A, ROCKFORD, IL 61107-6668
(815) 398-0303
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019020600
IL
Other
Enumeration date
10/04/2012
Last updated
10/04/2012
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