Individual
DR. MATTHEW JOSEPH LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
390 S WILCOX ST STE A, CASTLE ROCK, CO 80104-1951
(303) 660-6000
(303) 660-9745
Mailing address
1777 S HARRISON ST STE 1400, DENVER, CO 80210-3937
(303) 285-6098
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
203208
CO
Other
Enumeration date
06/18/2017
Last updated
06/18/2017
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