| NPI | 1124732698 |
|---|---|
| Doing Business As | LAKE BUTLER DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | MINH PHAM Owner 321-248-2923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-01-10 |
| Last Update Date | 2023-01-10 |