Organization
CEDAR LAKE DENTAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IAN HOFFMAN DDS (OWNER)
(773) 820-2587
Entity
Organization
Contact information
Practice address
13136 LAKE SHORE DR, CEDAR LAKE, IN 46303-9576
(219) 323-6777
Mailing address
1926 N LINCOLN PARK W APT 3B, CHICAGO, IL 60614-8017
(773) 820-2587
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
04/22/2025
Last updated
04/22/2025
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