| Westlake Dental Center | |
|
214 Washington St Ingleside IL 60041-9208 | |
| (847) 587-3020 | |
| (847) 587-1598 |
| Full Name | Westlake Dental Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 214 Washington St, Ingleside, Illinois |
| Authorized Official Name and Position | Min J Kwon (OWNER) |
| Authorized Official Contact | 8475873020 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Westlake Dental Center 214 Washington St Ingleside IL 60041-9208 Ph: (847) 587-3020 | Westlake Dental Center 214 Washington St Ingleside IL 60041-9208 Ph: (847) 587-3020 |
| NPI Number | 1134376189 |
|---|---|
| Provider Enumeration Date | 08/21/2008 |
| Last Update Date | 08/21/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134376189 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019026900 (Illinois) | Secondary |
| 1223G0001X | Dentist - General Practice | 019025326 (Illinois) | Primary |