| NPI | 1679822456 |
|---|---|
| Doing Business As | LAKESIDE DENTAL |
| Entity Type | Organization |
| Authorized Contact | NICHOLE DIMASCIO Office Manager 704-987-9087 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2012-09-07 |