Organization · Type 2 NPI
Cordell Lake, D.d.s., LLC
Dental Clinic/Center · Farmington, MO
NPI number
1619446077
Active
Practice location
12 E Harrison St
Farmington, MO 63640-1859
Mailing address
3145 Cross Creek Dr
Camdenton, MO 65020-9377
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | None listed |
Dental Clinic/Center: Definition to come...
2 other providers at this address
Other dental clinic/center providers in Farmington
About NPI 1619446077
Cordell Lake, D.d.s., LLC's National Provider Identifier is 1619446077, issued on Nov 15, 2018. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Farmington, MO. The record was last updated on Nov 15, 2018.