| NPI | 1033980495 |
|---|---|
| Doing Business As | LAKEHOUSE DENTAL |
| Entity Type | Organization |
| Authorized Contact | MUHAMMAD KHONDOKER Manager 704-887-2744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2024-01-12 |
| Last Update Date | 2025-02-09 |