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Individual

DR. DEREK JAMES BOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D., M.S.

Contact information

Practice address
840 S WAUKEGAN RD, SUITE 107, LAKE FOREST, IL 60045-2608
(847) 615-5437
(847) 615-2955
Mailing address
840 S WAUKEGAN RD, SUITE 107, LAKE FOREST, IL 60045-2608
(847) 615-5437
(847) 615-2955

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
021002219
IL

Other

Enumeration date
06/12/2008
Last updated
01/29/2009
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