| John F Lake Dds & Deborah Starr | |
|
286 Sw 4th St Ontario OR 97914-2610 | |
| (541) 889-7050 | |
| (541) 889-6495 |
| Full Name | John F Lake Dds & Deborah Starr |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 286 Sw 4th St, Ontario, Oregon |
| Authorized Official Name and Position | John F Lake (PRESIDENT) |
| Authorized Official Contact | 5418897050 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John F Lake Dds & Deborah Starr 286 Sw 4th St Ontario OR 97914-2610 Ph: (541) 889-7050 | John F Lake Dds & Deborah Starr 286 Sw 4th St Ontario OR 97914-2610 Ph: (541) 889-7050 |
| NPI Number | 1487862009 |
|---|---|
| Provider Enumeration Date | 05/18/2007 |
| Last Update Date | 01/26/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487862009 | NPI | - | NPPES |
| 226330 | Medicaid | OR | |
| 805738900 | Medicaid | ID | |
| 805738800 | Medicaid | ID | |
| 226329 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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