NPI | 1447604723 |
---|---|
Former Legal Business Name | LAKELANDS DENTAL ART |
Entity Type | Organization |
Authorized Contact | JENNIFER A TOMLINSON Credentialing Coordinator 864-229-6639 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Enumeration Date | 2016-04-22 |
Last Update Date | 2023-10-09 |