Organization
LAKE COOK DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROSE M LESNIAK DDS (PRESIDENT)
(847) 250-5580
Entity
Organization
Contact information
Practice address
115 W ORCHARD ST, ITASCA, IL 60143-1700
(847) 250-5580
Mailing address
115 W ORCHARD ST, ITASCA, IL 60143-1700
(847) 250-5580
(847) 250-5581
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
019025184
IL
Other
Enumeration date
01/28/2013
Last updated
01/28/2013
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