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1023132859
ORAL & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C.
GURNEE, IL
NPI
1023132859
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Entity Type
Organization
Authorized Contact
FABIAN DAVID LATOCHA
Owner
847-623-2830
Organization Subpart ?
No
Primary Taxonomy
1223P0106X Dentist Oral and Maxillofacial Pathology
Enumeration Date
2007-03-19
Last Update Date
2008-04-09
Business Address
ORAL & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C.
202 S GREENLEAF ST SUITE A
GURNEE, IL 60031-3399
Phone number: 847-623-2830
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Mailing Address
ORAL & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C.
202 S GREENLEAF ST SUITE A
GURNEE, IL 60031-3399
Phone number: 847-623-2830
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