| NPI | 1861118580 |
|---|---|
| Doing Business As | LAKEPOINT DENTAL |
| Entity Type | Organization |
| Authorized Contact | SIREESHA PENUMETCHA President 916-691-9191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 122300000X Dentist |
| 1223G0001X Dentist, General Practice | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| Enumeration Date | 2022-10-14 |
| Last Update Date | 2022-10-14 |