Organization
LAKE FOREST DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONIKA TINCHER (OWNER)
(805) 795-3618
Entity
Organization
Contact information
Practice address
133 E LAUREL AVE, LAKE FOREST, IL 60045-1326
(847) 234-6440
Mailing address
133 E LAUREL AVE, LAKE FOREST, IL 60045-1326
(847) 234-6440
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019.029812
IL
Other
Enumeration date
11/20/2015
Last updated
11/20/2015
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