Individual
DR. SCOTT ANTHONY LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
616 E MAIN, CHEWELAH, WA 99109
(509) 935-8642
Mailing address
PO BOX 347, CHEWELAH, WA 99109-0347
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
60096083
WA
Other
Enumeration date
08/06/2009
Last updated
08/06/2009
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