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Edward William Lake Dds Pc
Dental Clinic/Center in Potosi, Missouri
NPI 1063676369

Edward William Lake Dds Pc is a Dental Clinic/Center based in Potosi, MO and is specialized in Dental. Edward William Lake Dds Pc practices in Potosi, MO. The NPI Number for Edward William Lake Dds Pc is 1063676369 and holds a License No. 11627 (Missouri).

The current practice location address for Edward William Lake Dds Pc is 313 E High St, Potosi, MO and can be reached out via phone at 573-438-6277.

Location: 313 E High St, Potosi, MO, 63664-1924
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1063676369
Provider Name
Edward William Lake Dds Pc
Credential
Provider Entity Type
Organization
Address
313 E High St, Potosi, MO, 63664-1924
Phone Number
573-438-6277
Fax Number
Provider Enumeration Date
07/16/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
313 E High St
City
Potosi
State
Missouri
Zip
63664-1924
Phone Number
573-438-6277
Fax Number
person
Provider Business Mailing Address Details
Address
313 E High St
City
Potosi
State
Missouri
Zip
63664-1924
Phone Number
573-438-6277
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
261QD0000X
License No.
11627 (Missouri)
Definition
Definition to come...
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