Organization
COLLEGE AVENUE DENTAL SLEEP APPLIANCES LTD.
Active
Other names
Randall E Lawson DDS
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL EVERT LAWSON DDS (OWNER)
(217) 473-6758
Entity
Organization
Contact information
Practice address
505 W COLLEGE AVE, JACKSONVILLE, IL 62650-2405
(217) 245-5313
(217) 383-0204
Mailing address
505 W COLLEGE AVE, JACKSONVILLE, IL 62650-2405
(217) 245-5313
(217) 383-0204
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
019019857
IL
Other
Enumeration date
03/24/2014
Last updated
04/22/2014
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