| NPI | 1649668682 |
|---|---|
| Doing Business As | LAKELAND ENDODONTICS |
| Entity Type | Organization |
| Authorized Contact | KENDRA WALKER Credentialing COO Rdinator 217-540-8312 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: FL DN19410) |
| Enumeration Date | 2014-12-29 |
| Last Update Date | 2014-12-29 |