| NPI | 1073269494 |
|---|---|
| Doing Business As | SHORE LAKE DENTAL |
| Entity Type | Organization |
| Authorized Contact | BRANDON BOHRER Owner 585-507-2684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-02-24 |
| Last Update Date | 2022-02-24 |