Kenneth R Anderson, D.D.S Valid NPI
Individual provider · Dentist · Lake Forest, IL
- NPI
- 1992003370
- Type
- Individual (Type 1)
- Primary specialty
- Dentist
- Specialty group
- Dental Providers
- Taxonomy code
- 122300000X
- License number
- 019019692 (IL)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2011-03-08
- Last updated
- 2011-03-08
Practice location
810 S Waukegan Rd
Lake Forest, IL 60045-2693
(847) 295-0515