Organization
LAKEBRINK DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS G LAKEBRINK DDS (OWNER/DENTIST)
(816) 792-4455
Entity
Organization
Contact information
Practice address
105 N STEWART CT, SUITE 140, LIBERTY, MO 64068-1066
(816) 792-4455
Mailing address
105 N STEWART CT, SUITE 140, LIBERTY, MO 64068-1066
(816) 792-4455
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14423
MO
1223G0001X
General Practice Dentistry
2011014525
MO
Other
Enumeration date
08/06/2012
Last updated
08/06/2012
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