| NPI | 1689254757 |
|---|---|
| Former Legal Business Name | SMILE SUITES DENTAL, PLLC |
| Doing Business As | LAKETOWN FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | ERIC LENDBURGH HEISSER Member 231-670-2851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-04-12 |
| Last Update Date | 2022-03-04 |