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Individual

DR. LION GRENADER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
644 SHERIDAN RD # D, WINTHROP HARBOR, IL 60096-1350
(847) 872-5626
Mailing address
400 PENNY LN, GRAYSLAKE, IL 60030-3737

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019031298
IL

Other

Enumeration date
07/25/2017
Last updated
03/17/2018
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