Organization
RUSSELL P UMBRICHT DDS LTD
Active
Other names
Lathrop Oral Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL PAUL UMBRICHT (PRESIDENT OFFICER)
(708) 366-8907
Entity
Organization
Contact information
Practice address
404 LATHROP AVE, RIVER FOREST, IL 60305-1810
(708) 366-8909
(708) 366-8909
Mailing address
404 LATHROP AVE, RIVER FOREST, IL 60305-1810
(708) 366-8909
(708) 366-8909
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
060000462041138603
IL
Other
Enumeration date
05/21/2008
Last updated
05/21/2008
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