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Individual

DR. CHARLEEN J LAKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
321 N ADAMS ST, HINSDALE, IL 60521-3127
(630) 323-4971
Mailing address
321 N ADAMS ST, HINSDALE, IL 60521-3127
(630) 323-4971

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019016578
IL

Other

Enumeration date
12/19/2011
Last updated
12/19/2011
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