Provider First Line Business Practice Location Address:
245 N RAND RD
Provider Second Line Business Practice Location Address:
NEW AGE DENTAL ASSOCIATES
Provider Business Practice Location Address City Name:
LAKE ZURICH
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60047
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-438-3530
Provider Business Practice Location Address Fax Number:
847-438-3542
Provider Enumeration Date:
11/29/2006