| NPI | 1922266576 |
|---|---|
| Doing Business As | NORTHLAKE DENTAL |
| Entity Type | Organization |
| Authorized Contact | PATRICK SHANNON ALLISON Owner 985-626-3338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2020-07-31 |