Organization
LAKESHORE DENTAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL BOBROW DDS (OWNER)
(847) 835-1450
Entity
Organization
Contact information
Practice address
630 VERNON AVE, SUITE C, GLENCOE, IL 60022-1681
(847) 835-1450
(847) 835-0628
Mailing address
630 VERNON AVE, SUITE C, GLENCOE, IL 60022-1681
(847) 835-1450
(847) 835-0628
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019020613
IL
Other
Enumeration date
10/27/2010
Last updated
10/27/2010
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