Individual
DR. BRUCE CHISHOLM BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
625 WEST ROLLINS RD, ROUND LAKE BEACH, IL 60073
(847) 546-6644
(847) 546-6645
Mailing address
1443 NORTH WILLOW ST, LAKE FOREST, IL 60045
(847) 234-3014
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
15471
IL
Other
Enumeration date
07/28/2006
Last updated
07/08/2007
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