Organization
LAKE GENEVA DENTAL CARE, LLC
Active
Other names
Beloit Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE GROH DDS (OWNER/PRESIDENT)
(630) 833-5110
Entity
Organization
Contact information
Practice address
1454 E HUEBBE PKWY, BELOIT, WI 53511-1714
(608) 362-0672
(608) 362-4960
Mailing address
333 W 1ST ST, ELMHURST, IL 60126-2641
(630) 833-5110
(630) 833-0458
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
019014858
IL
Other
Enumeration date
09/13/2013
Last updated
09/13/2013
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