Organization
FOUR SEASONS DENTAL STUDIO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KIET H LAM DDS (PRESIDENT)
(773) 334-9922
Entity
Organization
Contact information
Practice address
2472 W. FOSTER AVE., SUITE 101, CHICAGO, IL 60625
(773) 220-8381
(773) 334-9928
Mailing address
2472 W FOSTER AVE, SUITE 101, CHICAGO, IL 60625-6962
(773) 220-8381
(773) 334-9928
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/06/2007
Last updated
09/05/2008
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