NPI | 1790543783 |
---|---|
Doing Business As | LAKEVIEW DENTAL AND WELLNESS |
Entity Type | Organization |
Authorized Contact | CHAD HENDRICKS Credentialing 612-859-0444 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2024-03-13 |
Last Update Date | 2024-03-13 |