Individual
STEVEN CHARRLES LAKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
151 BROADWAY, COLCHESTER, CT 06415
(860) 537-1444
(860) 537-6648
Mailing address
P.O BOX 166, COLCHESTER, CT 06415
(860) 537-1444
(860) 537-6648
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5290
CT
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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