| NPI | 1235649518 |
|---|---|
| Doing Business As | LAKELAND MODERN DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | MARY MABRY Owner Doctor 863-216-5765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2022-06-15 |