Lagrange Periodontics, Ltd

NPI 1023175775 - Dentist - 1223P0300X

NPI Details
NPI 1023175775
Enumeration Date 01/02/2007
Last Updated 01/31/2014
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name MICHELLE P MICHELLE
Position PRESIDENT/PERIODONTIST
Phone (708) 354-4545
Fax (708) 354-0336
Practice Location
475 W 55TH ST STE 201
COUNTRYSIDE IL, 60525-3566, US
Phone (708) 354-4545
Fax (708) 354-0336
Business Location
475 W 55TH ST STE 201
COUNTRYSIDE IL, 60525-3566, US
Phone (708) 354-4545
Fax (708) 354-0336
Toxanomy
Taxonomy Code 1223P0300X
License State Illinois
License Number 21001423
Remove 1023175775 NPI Number
 

According to our database, Lagrange Periodontics, Ltd NPI is 1023175775, taxonomy code is 1223P0300X and license number is 21001423, license state is located at Illinois. Lagrange Periodontics, Ltd physically located at 475 W 55th St Ste 201, Countryside IL, 60525-3566. NPI Number 1033115704 has the healthcare provider type.

Sponsored links

1023175775 NPI number is provided on an as is basis without warranty of any kind. 1023175775 is maintained by the National Plan & Provider Enumeration System. The contents of Lagrange Periodontics, Ltd are for informational purposes only.