Individual
MR. LEE R BOMGAARS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2634 GRAND AVE, #106, WAUKEGAN, IL 60085-2458
(847) 662-7588
(847) 662-3843
Mailing address
2634 GRAND AVE, #106, WAUKEGAN, IL 60085-2458
(847) 662-7588
(847) 662-3843
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
21000637
IL
Other
Enumeration date
12/05/2006
Last updated
07/08/2007
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