Organization
LRC PERIODONTICS AND IMPLANTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURA RICHARDS CAPATI DMD, MS (OWNER/PERIODONTIST)
(402) 943-7711
Entity
Organization
Contact information
Practice address
1099 BELT LINE RD, SUITE A, COLLINSVILLE, IL 62234-4380
(402) 943-7711
Mailing address
1099 BELT LINE RD, SUITE A, COLLINSVILLE, IL 62234-4380
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
019.027682
IL
Other
Enumeration date
10/19/2012
Last updated
10/19/2012
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