| NPI | 1063558617 |
|---|---|
| Doing Business As | LAKE SHORE FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | WALTER S HONG President 410-255-8001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MD 13307) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-08-22 |