Organization
LAKESIDE DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LULU GORES (ADMINISTRATOR)
(507) 282-8222
Entity
Organization
Contact information
Practice address
24 W SILVER LAKE DR NE, ROCHESTER, MN 55906-3640
(507) 282-8222
Mailing address
24 W SILVER LAKE DR NE, ROCHESTER, MN 55906-3640
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/16/2008
Last updated
04/16/2008
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