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1992003370
KENNETH R ANDERSON
LAKE FOREST, IL
NPI
1992003370
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: IL 019019692)
Enumeration Date
2011-03-08
Last Update Date
2011-03-08
Business Address
Dr. KENNETH R ANDERSON D.D.S
810 S WAUKEGAN RD
LAKE FOREST, IL 60045-2693
Phone number: 847-295-0515
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Mailing Address
Dr. KENNETH R ANDERSON D.D.S
810 S WAUKEGAN RD
LAKE FOREST, IL 60045-2693
Phone number: 847-295-0515
Copy
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