| Gilbert J Lafemina Dds Ltd | |
|
345 E Burlington St Riverside IL 60546-2188 | |
| (708) 447-6670 | |
| (708) 447-6673 |
| Full Name | Gilbert J Lafemina Dds Ltd |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 345 E Burlington St, Riverside, Illinois |
| Authorized Official Name and Position | Gilbert J Lafemina (PRESIDENT) |
| Authorized Official Contact | 7084476670 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gilbert J Lafemina Dds Ltd 345 E Burlington St Ste B1 Riverside IL 60546-2084 Ph: (708) 447-6670 | Gilbert J Lafemina Dds Ltd 345 E Burlington St Riverside IL 60546-2188 Ph: (708) 447-6670 |
| NPI Number | 1003112632 |
|---|---|
| Provider Enumeration Date | 01/29/2011 |
| Last Update Date | 12/16/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003112632 | NPI | - | NPPES |
| 6489850001 | Other | IL | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 019015136 (Illinois) | Primary |
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