Organization
PEDIATRIC DENTAL SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JANICE A LUBAS DDS (SECRETARY)
(708) 424-1300
Entity
Organization
Contact information
Practice address
6305 W 95TH ST, OAK LAWN, IL 60453-2255
(708) 424-1300
Mailing address
6305 W 95TH ST, OAK LAWN, IL 60453-2255
(708) 424-1300
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
019020526
IL
Other
Enumeration date
10/22/2015
Last updated
10/23/2015
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