Individual
DR. EDWARD PETER LACO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
309 E RIVERSIDE BLVD, LOVES PARK, IL 61111-4520
(815) 633-1815
(815) 633-1627
Mailing address
309 E RIVERSIDE BLVD, LOVES PARK, IL 61111-4520
(815) 633-1815
(815) 633-1627
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019-025905
IL
Other
Enumeration date
07/28/2006
Last updated
09/26/2011
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