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Individual

JOHN F LAKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

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
7733
OR

Other

Enumeration date
08/19/2006
Last updated
02/10/2016
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