| NPI | 1891669727 |
|---|---|
| Doing Business As | LAKE FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | MATTHEW BRYANT LAKE Practice Owner 541-686-1199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2025-10-02 |
| Last Update Date | 2025-10-02 |