| NPI | 1225468812 |
|---|---|
| Doing Business As | SPENCER & LAKES REGIONAL ORAL & MAXILLOFACIAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | KAREN POTACZEK Owner 712-262-7350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2013-11-18 |
| Last Update Date | 2014-02-11 |