Individual
RUBY J LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16 STRAND STREET, FREDERIKSTED, VI 00840
(340) 772-1616
(340) 772-1616
Mailing address
414 STRAND STREET, FREDERIKSTED, VI 00840
(340) 772-1616
(340) 772-1616
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
708
VI
Other
Enumeration date
10/18/2012
Last updated
10/18/2012
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