Organization
LAKE FOREST DENTAL ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD D. COTTRELL D.D.S. (OWNER)
(847) 234-6440
Entity
Organization
Contact information
Practice address
133 E LAUREL AVE, LAKE FOREST, IL 60045-1205
(847) 234-6440
(847) 234-2195
Mailing address
133 E LAUREL AVE, LAKE FOREST, IL 60045-1205
(847) 234-6440
(847) 234-2195
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
019.014822
IL
Other
Enumeration date
08/12/2008
Last updated
08/12/2008
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