Individual
DR. KENNETH R ANDERSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
810 S WAUKEGAN RD, LAKE FOREST, IL 60045-2693
(847) 295-0515
Mailing address
810 S WAUKEGAN RD, LAKE FOREST, IL 60045-2693
(847) 295-0515
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019019692
IL
Other
Enumeration date
03/08/2011
Last updated
03/08/2011
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