| Lake Dental Pllc | |
|
2200 London Rd Duluth MN 55812-2129 | |
| (218) 728-4272 | |
| Not Available |
| Full Name | Lake Dental Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2200 London Rd, Duluth, Minnesota |
| Authorized Official Name and Position | Robert David Lacosse (CEO) |
| Authorized Official Contact | 2187284272 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Dental Pllc 2200 London Road Duluth MN 55812-2129 Ph: () - | Lake Dental Pllc 2200 London Rd Duluth MN 55812-2129 Ph: (218) 728-4272 |
| NPI Number | 1518132117 |
|---|---|
| Provider Enumeration Date | 04/24/2008 |
| Last Update Date | 04/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518132117 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D10551 (Minnesota) | Primary |
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