| Organization Name: | DM FAMILY DENTISTRY INC |
| NPI Number: | 1871800656 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DORIS MADRIGAL (DENTIST/CEO) |
| Mailing Address: | 1228 N Cedar Lake Rd Round Lake Beach |
| State: | IL US |
| Postal Code: | 600732556 |
| Phone Number: | 8477408827 |
| Fax Number: | 8477407388 |
| NPI Enumeration Date: | 09/01/2010 |
| NPI Last Update Date: | 09/01/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 019022762 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |