| NPI | 1811426810 |
|---|---|
| Doing Business As | LAKE BLUFF DENTAL |
| Entity Type | Organization |
| Authorized Contact | CAROLYN GRIFFIN Dentist 414-962-1800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: WI 7054-15) |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2018-06-16 |