Organization
LAKE RIDGE PEDIATRIC DENTISTRY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANDON DAVID CESARIO DMD (DENTIST)
(219) 228-8588
Entity
Organization
Contact information
Practice address
620 RIDGE RD, MUNSTER, IN 46321-1610
(219) 228-8588
Mailing address
620 RIDGE RD, MUNSTER, IN 46321-1610
(219) 228-8588
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
05/18/2023
Last updated
05/18/2023
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