| NPI | 1689340192 |
|---|---|
| Doing Business As | LAKEWOOD DENTAL STUDIO |
| Entity Type | Organization |
| Authorized Contact | LEISA ROBOTHAM-REID Managing Member 917-873-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2021-08-17 |