| NPI | 1548155351 |
|---|---|
| Doing Business As | LAKELINE FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | SHIPRA GUPTA Managing Member 312-607-1103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2025-06-11 |
| Last Update Date | 2025-09-21 |