Organization
DISTINCTIVE DENTAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE PATRICK SMITH D.D.S. (OWNER)
(708) 386-0177
Entity
Organization
Contact information
Practice address
185 N MARION ST, OAK PARK, IL 60301-1513
(708) 386-0177
(708) 386-8897
Mailing address
185 N MARION ST, OAK PARK, IL 60301-1513
(708) 386-0177
(708) 386-8897
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
01901923
IL
Other
Enumeration date
05/23/2008
Last updated
05/23/2008
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