Organization
RAVENSWOOD DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENRY LOTSOF DDS (PRESIDENT)
(773) 334-3555
Entity
Organization
Contact information
Practice address
5015 N PAULINA ST, SUITE 330, CHICAGO, IL 60640-2756
(773) 334-3555
(773) 334-5771
Mailing address
5015 N PAULINA ST, SUITE 330, CHICAGO, IL 60640-2756
(773) 334-3555
(773) 334-5771
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019019228
IL
Other
Enumeration date
09/03/2008
Last updated
09/03/2008
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