Organization
LAKES REGIONAL ORAL & MAXILLOFACIAL SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN R EVELHOCH MD (OWNER)
(712) 264-8390
Entity
Organization
Contact information
Practice address
116 E 11TH ST, SUITE 203, SPENCER, IA 51301-4364
(712) 264-8390
(712) 264-8391
Mailing address
116 E 11TH ST, SUITE 203, SPENCER, IA 51301-4364
(712) 264-8390
(712) 264-8391
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
IA
Other
Enumeration date
11/26/2008
Last updated
11/26/2008
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