Organization
JOHN F LAKE DDS & DEBORAH STARR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN F LAKE DDS (PRESIDENT)
(541) 889-7050
Entity
Organization
Contact information
Practice address
286 SW 4TH ST, ONTARIO, OR 97914-2610
(541) 889-7050
(541) 889-6495
Mailing address
286 SW 4TH ST, ONTARIO, OR 97914-2610
(541) 889-7050
(541) 889-6495
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
226329
—
OR
05
—
226330
—
OR
05
—
805738800
—
ID
05
—
805738900
—
ID
Enumeration date
05/18/2007
Last updated
01/26/2016
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