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Individual

DR. ROBERT THOMAS LESAGE JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
815 N GALENA AVE, DIXON, IL 61021-1518
(815) 288-1418
Mailing address
815 N GALENA AVE, DIXON, IL 61021-1518
(815) 288-1418

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19A13394
IL

Other

Enumeration date
03/01/2012
Last updated
03/01/2012
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