Organization
CEDAR LAKE DENTAL, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAUREEN COPELAND (PRESIDENT)
(847) 201-1102
Entity
Organization
Contact information
Practice address
1849 S CEDAR LAKE RD, ROUND LAKE, IL 60073-5711
(847) 201-1102
Mailing address
1849 S CEDAR LAKE RD, ROUND LAKE, IL 60073-5711
(847) 201-1102
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019027730
IL
Other
Enumeration date
11/06/2015
Last updated
11/06/2015
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