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1083638399
KEVIN JOSEPH LAKE
NEW PROVIDENCE, NJ
NPI
1083638399
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: NJ 22DI02044100)
Enumeration Date
2006-07-27
Last Update Date
2007-07-08
Business Address
Dr. KEVIN JOSEPH LAKE DMD
5 ETHAN DR
NEW PROVIDENCE, NJ 07974-1604
Phone number: 908-464-5270
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Mailing Address
Dr. KEVIN JOSEPH LAKE DMD
5 ETHAN DR
NEW PROVIDENCE, NJ 07974-1604
Phone number: 908-464-5270
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