| James Lake Dds Inc | |
|
57340 29 Palms Hwy Yucca Valley CA 92284-2927 | |
| (760) 365-0774 | |
| (760) 365-3995 |
| Full Name | James Lake Dds Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 57340 29 Palms Hwy, Yucca Valley, California |
| Authorized Official Name and Position | James Alan Lake (PRESIDENT) |
| Authorized Official Contact | 7603650774 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| James Lake Dds Inc 57340 29 Palms Hwy Yucca Valley CA 92284-2927 Ph: (760) 365-0774 | James Lake Dds Inc 57340 29 Palms Hwy Yucca Valley CA 92284-2927 Ph: (760) 365-0774 |
| NPI Number | 1659861599 |
|---|---|
| Provider Enumeration Date | 05/16/2018 |
| Last Update Date | 05/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659861599 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 59657 (California) | Primary |
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