| NPI | 1447657234 |
|---|---|
| Doing Business As | GREAT LAKES DENTAL SOLUTIONS |
| Entity Type | Organization |
| Authorized Contact | ANSHUMAN SONI President / Dentist 815-209-6272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019026289) |
| Enumeration Date | 2014-11-23 |
| Last Update Date | 2014-12-16 |