| Lake Dental Group | |
|
4340 Newman Rd. Racine WI 53406 | |
| (262) 633-0775 | |
| Not Available |
| Full Name | Lake Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 4340 Newman Rd., Racine, Wisconsin |
| Authorized Official Name and Position | Margaret Aboagye (CEO) |
| Authorized Official Contact | 2626336117 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Dental Group 4340 Newman Rd. Racine WI 53406 Ph: () - | Lake Dental Group 4340 Newman Rd. Racine WI 53406 Ph: (262) 633-0775 |
| NPI Number | 1386185106 |
|---|---|
| Provider Enumeration Date | 03/13/2017 |
| Last Update Date | 03/13/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386185106 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 1629150289 (Wisconsin) | Primary |
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