Organization
LAFAZANOS DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SPIROS J LAFAZANOS DDS (CEO)
(815) 455-5490
Entity
Organization
Contact information
Practice address
820 E TERRA COTTA AVE, SUITE 218/220, CRYSTAL LAKE, IL 60014-3649
(815) 455-5490
(815) 455-5498
Mailing address
820 E TERRA COTTA AVE, SUITE 218/220, CRYSTAL LAKE, IL 60014-3649
(815) 455-5490
(815) 455-5498
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019023307
IL
Other
Enumeration date
02/22/2010
Last updated
02/22/2010
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