Individual
DEBORAH STARR LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
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
7734
OR
Other
Enumeration date
08/19/2006
Last updated
07/08/2007
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