M Lauck Sc
Dentist, Oral and Maxillofacial Surgery in Elmhurst, IL. Organization (NPI-2).
NPI number1295909240
StatusActive
Last updated in NPPESApr 24, 2008
Details
- NPI
- 1295909240
- Entity type
- Organization (NPI-2)
- Legal business name
- M Lauck Sc
- Organization subpart
- No
- Enumeration date
- Apr 19, 2008
- Last updated
- Apr 24, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | 019013525 | IL | Yes |
Practice location
360 W Butterfield RdSuite 220
Elmhurst, IL 60126-5068
Phone 630-833-0395
Mailing address
360 W Butterfield RdSuite 220
Elmhurst, IL 60126-5068
Phone 630-833-0395
Authorized official
Michael James Lauck
President
6308330395
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