| NPI | 1215515085 |
|---|---|
| Doing Business As | LAKE LUCERNE LIFESTYLE DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | GUSTAVO DE OLIVEIRA Owner 407-425-4901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2021-04-27 |