NPI | 1659779569 |
---|---|
Doing Business As | LINCOLN CROSSING FAMILY DENTAL |
Entity Type | Organization |
Authorized Contact | TRENEICE MANGRAM President/Dentist 708-799-4203 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019026308) |
Enumeration Date | 2014-12-09 |
Last Update Date | 2014-12-09 |