Individual
DR. KENNETH MICHAEL LUTSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
619 HARLEM RD, MACHESNEY PARK, IL 61115-2429
(815) 877-8800
(815) 877-8805
Mailing address
619 HARLEM RD, MACHESNEY PARK, IL 61115-2429
(815) 877-8800
(815) 877-8805
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.020868
IL
Other
Enumeration date
03/19/2007
Last updated
07/08/2007
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