Provider Demographics
NPI:1073688321
Name:LAWRENCE J MEEKMA DDS LTD
Entity Type:Organization
Organization Name:LAWRENCE J MEEKMA DDS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MEEKMA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:708-448-3399
Mailing Address - Street 1:7400 COLLEGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463
Mailing Address - Country:US
Mailing Address - Phone:708-448-3399
Mailing Address - Fax:708-448-2646
Practice Address - Street 1:7400 COLLEGE DRIVE
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463
Practice Address - Country:US
Practice Address - Phone:708-448-3399
Practice Address - Fax:708-448-2646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19A15669122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty