| NPI | 1629719232 |
|---|---|
| Doing Business As | LAKESIDE DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | VASANTH KRISHNASWAMI Office Manage 734-223-7586 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-04-06 |
| Last Update Date | 2022-04-06 |