CORDELL LAKE

FARMINGTON, MO
NPI1255744405
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy122300000X Dentist
(Licence: MO  2014016814)
Enumeration Date2014-06-05
Last Update Date2019-03-04
Business Address
Dr. CORDELL LAKE DDS
12 E HARRISON ST
FARMINGTON, MO 63640-1859
Phone number: 573-756-4344
Mailing Address
Dr. CORDELL LAKE DDS
12 E HARRISON ST
FARMINGTON, MO 63640-1859
Phone number:
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