TERRY L LAKE

SOUTH CHARLESTON, WV
NPI1174529903
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: WV  2379WV)
Enumeration Date2005-06-27
Last Update Date2007-07-08
Business Address
Dr. TERRY L LAKE D.M.D.
5001 MACCORKLE AVE SW
SOUTH CHARLESTON, WV 25309-1217
Phone number: 304-768-5721
Mailing Address
Dr. TERRY L LAKE D.M.D.
5001 MACCORKLE AVE SW
SOUTH CHARLESTON, WV 25309-1217
Phone number: 304-768-5721
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