Organization · Type 2 NPI
Edward William Lake DDS PC
Dental Clinic/Center · Potosi, MO
NPI number
1063676369
Active
Practice location
313 E High St
Potosi, MO 63664-1924
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | 11627 (MO) |
Dental Clinic/Center: Definition to come...
Another provider at this address
About NPI 1063676369
Edward William Lake DDS PC's National Provider Identifier is 1063676369, issued on Jul 16, 2008. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Potosi, MO. The record was last updated on Jul 16, 2008.