Robert T. Lesage
Dentist, General Practice in Dixon, IL. Organization (NPI-2).
NPI number1528085271
StatusActive
Last updated in NPPESOct 22, 2012
Details
- NPI
- 1528085271
- Entity type
- Organization (NPI-2)
- Legal business name
- Robert T. Lesage
- Organization subpart
- No
- Enumeration date
- Jul 17, 2006
- Last updated
- Oct 22, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 19a13394 | IL | Yes |
Other names
- Lesage Dental Clinic Ltd (Other Name)
Practice location
815 N Galena AveDixon, IL 61021-1518
Phone 815-288-1418
Mailing address
815 N Galena AveDixon, IL 61021-1518
Authorized official
Robert Thomas Lesage
Dentist
8152881418
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All 12 General Practice Dentistry providers in Dixon · All 830 providers in Dixon
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