Individual
DR. MICHAEL LEE PRIMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
860 WAVELAND RD, LAKE FOREST, IL 60045-3944
(847) 234-2416
Mailing address
860 WAVELAND RD, LAKE FOREST, IL 60045-3944
(847) 234-2416
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019-013904
IL
Other
Enumeration date
08/29/2006
Last updated
02/05/2009
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