Organization
FARMINGTON LAKES DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KABIL CHUNPRAPAPH D.M.D. (PRESIDENT)
(331) 212-5085
Entity
Organization
Contact information
Practice address
1241 FARMINGTON LAKES DR, OSWEGO, IL 60543-5109
(331) 212-5085
Mailing address
1241 FARMINGTON LAKES DR, OSWEGO, IL 60543-5109
(331) 212-5085
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019025947
IL
Other
Enumeration date
11/03/2012
Last updated
11/03/2012
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