| NPI | 1104954478 |
|---|---|
| Doing Business As | LAKEWOOD DENTAL |
| Entity Type | Organization |
| Authorized Contact | TERUYUKI HATAKEYAMA President Owner 847-669-4088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019019002) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-08-22 |