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1619446077
CORDELL LAKE, D.D.S., LLC
FARMINGTON, MO
NPI
1619446077
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Entity Type
Organization
Authorized Contact
CORDELL LAKE
General Dentist
816-728-1630
Organization Subpart ?
No
Primary Taxonomy
261QD0000X Clinic/Center, Dental
Enumeration Date
2018-11-15
Last Update Date
2018-11-15
Business Address
CORDELL LAKE, D.D.S., LLC
12 E HARRISON ST
FARMINGTON, MO 63640-1859
Phone number: 573-756-4344
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Mailing Address
CORDELL LAKE, D.D.S., LLC
3145 CROSS CREEK DR
CAMDENTON, MO 65020-9377
Phone number: 816-728-1630
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