| NPI | 1265677314 |
|---|---|
| Former Legal Business Name | LAKEVIEW DENTAL CARE, P.C. |
| Entity Type | Organization |
| Authorized Contact | SAM TAHBAZ President 312-573-0007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019024892) |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2008-12-03 |