Individual
DR. TIMOTHY SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
950 N WESTERN AVE, LAKE FOREST, IL 60045-1742
(847) 234-0344
(847) 234-0568
Mailing address
950 N WESTERN AVE, LAKE FOREST, IL 60045-1742
(847) 234-0344
(847) 234-0568
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
091001682
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
091001682
IL
Other
Enumeration date
03/23/2010
Last updated
03/23/2010
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