| Edward William Lake Dds Pc | |
|
313 E High St Potosi MO 63664-1924 | |
| (573) 438-6277 | |
| Not Available |
| Full Name | Edward William Lake Dds Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 313 E High St, Potosi, Missouri |
| Authorized Official Name and Position | Edward William Lake (PRESIDENT) |
| Authorized Official Contact | 5734386277 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edward William Lake Dds Pc 313 E High St Potosi MO 63664-1924 Ph: (573) 438-6277 | Edward William Lake Dds Pc 313 E High St Potosi MO 63664-1924 Ph: (573) 438-6277 |
| NPI Number | 1063676369 |
|---|---|
| Provider Enumeration Date | 07/16/2008 |
| Last Update Date | 07/16/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063676369 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 11627 (Missouri) | Primary |
Nikodem And Hill Family Dental And Ortho Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Health Way Dr Ste 1, Potosi, MO 63664 Phone: 573-438-2118 |