Organization
LAKEVIEW SMILES MIDWAY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE H LEE DDS (PRESIDENT)
(773) 929-1150
Entity
Organization
Contact information
Practice address
5208 S CICERO AVE, CHICAGO, IL 60638-3043
(312) 764-1470
(773) 527-2003
Mailing address
5208 S CICERO AVE, CHICAGO, IL 60638-3043
(312) 764-1470
(773) 527-2003
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/22/2022
Last updated
02/22/2022
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