| NPI | 1134625031 |
|---|---|
| Doing Business As | LAKESHORE DENTAL STUDIO |
| Entity Type | Organization |
| Authorized Contact | KAPIL KELLA Dentist/Owner 989-714-3142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IL 019.029212) |
| Enumeration Date | 2018-04-01 |
| Last Update Date | 2018-04-01 |