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General NPI Number Information
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NPI Number | 1073688321
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Entity Type | Organization
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Legal Business Name | LAWRENCE J MEEKMA DDS LTD
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 04/19/2012
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Provider Practice Location Address
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Address Line | 7400 COLLEGE DRIVE
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463
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Country | US
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Telephone | 708-448-3399
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Fax | 708-448-2646
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Provider Business Mailing Address
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Address Line | 7400 COLLEGE DRIVE
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463
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Country | US
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Telephone | 708-448-3399
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Fax | 708-448-2646
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LAWRENCE JOHN MEEKMA
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Credential | DDS
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Telephone | 708-448-3399
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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 | 19A15669
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License Number State | IL
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