Individual
DR. STEPHANIE LOUISE LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
17110 LAKESIDE HILLS PLZ, OMAHA, NE 68130-5600
(402) 718-8737
Mailing address
2612 N 179TH ST, OMAHA, NE 68116-2267
(492) 733-1325
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6558
NE
Other
Enumeration date
06/21/2006
Last updated
06/16/2023
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