Individual
DR. ROBERTO LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
106 SHOPPERS WAY STE 108, BRUNSWICK, GA 31525-0522
(912) 342-7622
Mailing address
106 SHOPPERS WAY STE 108, BRUNSWICK, GA 31525-0522
(912) 342-7622
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
DN122646
GA
Other
Enumeration date
05/24/2022
Last updated
05/24/2022
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