| NPI | 1245494814 |
|---|---|
| Other Name | LAKETOWN DENTAL |
| Entity Type | Organization |
| Authorized Contact | JACLYN DUBOUE Managing Member Of LLC/Owner/Provid 225-926-0702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: LA 5635) |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2025-07-31 |