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General NPI Number Information
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NPI Number | 1063809382
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Entity Type | Individual
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Provider Name | COLLEEN FINLAY
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Gender | Female
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Dates
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Enumeration Date | 04/24/2015
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Last Update Date | 01/02/2016
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Provider Practice Location Address
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Address Line | 152 N RANDALL RD
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City | LAKE IN THE HILLS
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State | IL
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Zip | 60156-4471
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Country | US
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Telephone | 847-854-8555
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Fax |
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Provider Business Mailing Address
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Address Line | 152 N RANDALL RD
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City | LAKE IN THE HILLS
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State | IL
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Zip | 60156-4471
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019030392
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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