Individual
LANIEL RAZDOLSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
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
122300000X
Dentist
Primary
019029812
IL
Other
Enumeration date
06/18/2014
Last updated
10/26/2015
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