| Lakeshore Pediatric Dentistry Pllc | |
|
2993 Main St Ste 2 Peru NY 12972-2927 | |
| (518) 282-5519 | |
| Not Available |
| Full Name | Lakeshore Pediatric Dentistry Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2993 Main St Ste 2, Peru, New York |
| Authorized Official Name and Position | Colleen Marie Lacombe-senecal (PEDIATRIC DENTIST/OWNER) |
| Authorized Official Contact | 5185785295 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeshore Pediatric Dentistry Pllc 2993 Main St Ste 2 Peru NY 12972-2927 Ph: (518) 282-5519 | Lakeshore Pediatric Dentistry Pllc 2993 Main St Ste 2 Peru NY 12972-2927 Ph: (518) 282-5519 |
| NPI Number | 1114586625 |
|---|---|
| Provider Enumeration Date | 06/08/2019 |
| Last Update Date | 06/08/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114586625 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |