| Lake Quality Dental | |
|
723 Cr 466 Lady Lake FL 32159 | |
| (352) 430-0543 | |
| (352) 430-0702 |
| Full Name | Lake Quality Dental |
|---|---|
| Speciality | Dentist |
| Location | 723 Cr 466, Lady Lake, Florida |
| Authorized Official Name and Position | Phuong Ta (PRESIDENT / OWNER) |
| Authorized Official Contact | 3522555538 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Quality Dental 440 Chinahill Ct Apopka FL 32712 Ph: (352) 430-0543 | Lake Quality Dental 723 Cr 466 Lady Lake FL 32159 Ph: (352) 430-0543 |
| NPI Number | 1053662395 |
|---|---|
| Provider Enumeration Date | 09/26/2012 |
| Last Update Date | 09/26/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053662395 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | ND14668 (Florida) | Primary |
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