| NPI | 1114226081 |
|---|---|
| Doing Business As | LAKE SHORE DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | NGOC-BICH THI NGUYEN President 773-369-5536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019027633) |
| Enumeration Date | 2011-03-17 |
| Last Update Date | 2011-03-17 |