| NPI | 1841357084 |
|---|---|
| Doing Business As | LAKESIDE DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | ROBERT G. BRUNETTI C.E.O. 847-640-1112 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 060-008822) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2008-06-18 |