| NPI | 1225384746 |
|---|---|
| Doing Business As | EDWARDS LAKE DENTAL |
| Entity Type | Organization |
| Authorized Contact | ANDREW JASON LANGE Owner 205-655-8090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 5760) |
| Enumeration Date | 2012-08-02 |
| Last Update Date | 2012-08-02 |