| NPI | 1548607633 |
|---|---|
| Doing Business As | LAKESIDE ORAL SURGERY & DENTAL IMPLANTS |
| Entity Type | Organization |
| Authorized Contact | JOHN ROBERT HAYNIE Owner 614-460-1181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: ID N-13145) |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2013-05-29 |