| NPI | 1043645963 |
|---|---|
| Doing Business As | SEVEN LAKES DENTAL |
| Entity Type | Organization |
| Authorized Contact | BRAD A LARREAU Member 316-617-5888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA 60074615) |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2013-09-10 |