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Organization · General Practice Dentistry · Waukegan, IL

NPI
1053706481
Type
Organization (Type 2)
Primary specialty
General Practice Dentistry (Dentist)
Specialty group
Dental Providers
Taxonomy code
1223G0001X
License number
019021973 (IL)
Enumerated
2015-04-02
Last updated
2015-04-02
Practice location
2841 Grand Ave
Waukegan, IL 60085-2372
(847) 360-1610

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