Lakewood Family Dental

LBN: Lakewood Family Dental
Lakewood Family Dental is an health care organization with primary practice located at 1407 N Veterans Pkwy Suite 12, Bloomington IL 61704-6630. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Lakewood Family Dental can be contacted via phone (732) 379-0953, or through Kakollu, Srinivasulu via phone (732) 379-0953.

Contact Information

Primary practice address
1407 N Veterans Pkwy Suite 12 Bloomington IL 61704-6630
Phone: (732) 379-0953
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Kakollu, Srinivasulu Doctor of Dental Surgery (DDS)
Phone: (732) 379-0953

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 019-028401 Illinois

Profile Details

NPI number 1154675304
LBN Legal business name Lakewood Family Dental
DBA Doing business as
Authorized official Kakollu, Srinivasulu Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 8th, 2012
Last updated Nov 8th, 2012 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Popular Providers