Individual
DR. VALERIE E LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
6211 COVINGTON RD, FORT WAYNE, IN 46804-7311
(260) 432-1579
(260) 432-4540
Mailing address
6211 COVINGTON RD, FORT WAYNE, IN 46804-7311
(260) 432-1579
(260) 432-4540
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010452A
IN
Other
Enumeration date
04/03/2007
Last updated
11/08/2021
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