| Lake George Dental | |
|
163 W 1st Ave Pierson FL 32180-2200 | |
| (386) 202-3001 | |
| (386) 202-3002 |
| Full Name | Lake George Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 163 W 1st Ave, Pierson, Florida |
| Authorized Official Name and Position | David Edward Turner (PRESIDENT) |
| Authorized Official Contact | 3862023001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake George Dental 163 W 1st Ave P.o. Box 960 Pierson FL 32180-2200 Ph: (386) 202-3001 | Lake George Dental 163 W 1st Ave Pierson FL 32180-2200 Ph: (386) 202-3001 |
| NPI Number | 1588973093 |
|---|---|
| Provider Enumeration Date | 09/30/2010 |
| Last Update Date | 09/30/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588973093 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN14796 (Florida) | Primary |