| NPI | 1881172120 |
|---|---|
| Doing Business As | LAKESHORE DENTAL |
| Entity Type | Organization |
| Authorized Contact | JENNIFER EILEEN RICHEY Office Manager 480-838-5422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2018-07-30 |