Individual
DR. ULRICH LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
100 RIVER PLACE, STE 110, MADISON, WI 53716
(608) 222-6160
(608) 222-6248
Mailing address
100 RIVER PLACE, STE 110, MADISON, WI 53716
(608) 222-6160
(608) 222-6248
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
4288015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33762600
—
WI
Enumeration date
10/12/2006
Last updated
07/08/2007
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