| NPI | 1194365643 |
|---|---|
| Doing Business As | LAKE DENTAL |
| Entity Type | Organization |
| Authorized Contact | LINDSEY D BURBANK Owner 352-250-7079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-01-13 |
| Last Update Date | 2020-01-13 |