Organization
LAKE COUNTRY DENTAL P.L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA KAY MULKIN D.D.S. (OWNER/DENTIST)
(315) 789-3067
Entity
Organization
Contact information
Practice address
404 WILLIAM ST STE 5, GENEVA, NY 14456-2143
(315) 789-3067
(315) 789-0056
Mailing address
404 WILLIAM ST STE 5, GENEVA, NY 14456-2143
(315) 789-3067
(315) 789-0056
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
050514
NY
Other
Enumeration date
06/12/2017
Last updated
07/21/2022
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