| NPI | 1831669886 |
|---|---|
| Doing Business As | DENTISTRY AT THE LAKE |
| Entity Type | Organization |
| Authorized Contact | ANNA LUKIC Owner 704-209-9913 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2018-12-03 |
| Last Update Date | 2018-12-03 |