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Organization

LAKEWOOD DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GENIE KUBLE (CONTACT OFFICER)
(920) 450-0157
Entity
Organization

Contact information

Practice address
4131 26TH STREET NW, SUITE 1, ROCHESTER, MI 55904
(507) 282-8082
Mailing address
4131 26TH ST NW, SUITE 1, ROCHESTER, MN 55901-8342

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
03/06/2007
Last updated
09/18/2007
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