| NPI | 1598209207 |
|---|---|
| Doing Business As | LAKE AREA DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | JEFFERY ALLEN HENNIGAN Owner/Dentist 337-786-6221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: LA LA-6269) |
| Enumeration Date | 2016-12-14 |
| Last Update Date | 2016-12-14 |