| NPI | 1871702985 |
|---|---|
| Doing Business As | CRYSTAL LAKE DENTAL ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | PHILLIP C NEAL President 815-459-9389 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 1915895) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-08-22 |