Organization
HAMILTON LAKES DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MADGE PIERCE (OFFICE MANAGER)
(630) 773-6966
Entity
Organization
Contact information
Practice address
500 PARK BLVD, SUITE 180C, ITASCA, IL 60143
(630) 773-6966
(630) 773-6971
Mailing address
500 PARK BLVD, SUITE 180C, ITASCA, IL 60143
(630) 773-6966
(630) 773-6971
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
TIN
IL
Other
Enumeration date
01/16/2007
Last updated
07/21/2022
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