Organization
LAKE DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT DAVID LACOSSE (CEO)
(218) 728-4272
Entity
Organization
Contact information
Practice address
2200 LONDON RD, DULUTH, MN 55812-2129
(218) 728-4272
Mailing address
2200 LONDON ROAD, DULUTH, MN 55812-2129
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10551
MN
Other
Enumeration date
04/24/2008
Last updated
04/24/2008
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