| Valerie E Lake, Dds, Llc | |
|
6211 Covington Rd Fort Wayne IN 46804-7311 | |
| (260) 432-1579 | |
| (260) 432-4540 |
| Full Name | Valerie E Lake, Dds, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 6211 Covington Rd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Valerie E Lake (MEMBER) |
| Authorized Official Contact | 2604321579 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Valerie E Lake, Dds, Llc 6211 Covington Rd Fort Wayne IN 46804-7311 Ph: (260) 432-1579 | Valerie E Lake, Dds, Llc 6211 Covington Rd Fort Wayne IN 46804-7311 Ph: (260) 432-1579 |
| NPI Number | 1053062430 |
|---|---|
| Provider Enumeration Date | 01/17/2022 |
| Last Update Date | 03/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053062430 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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