| NPI | 1518691930 |
|---|---|
| Doing Business As | LAKEWOOD DENTAL |
| Entity Type | Organization |
| Authorized Contact | KEVIN ROWAN CEO 662-316-5272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-07-12 |
| Last Update Date | 2022-07-12 |