| Leix Dental Pc | |
|
8505 Redtail Drive Suite J Village Of Lakewood IL 60014 | |
| (815) 455-8186 | |
| (815) 455-8188 |
| Full Name | Leix Dental Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 8505 Redtail Drive, Village Of Lakewood, Illinois |
| Authorized Official Name and Position | Nirvana L Leix (PRESIDENT) |
| Authorized Official Contact | 8154558186 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leix Dental Pc 8505 Redtail Drive Suite J Village Of Lakewood IL 60014 Ph: (815) 455-8186 | Leix Dental Pc 8505 Redtail Drive Suite J Village Of Lakewood IL 60014 Ph: (815) 455-8186 |
| NPI Number | 1679740138 |
|---|---|
| Provider Enumeration Date | 05/14/2008 |
| Last Update Date | 05/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679740138 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |