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Contact Information

LAKEHAVEN DENTAL P.C
200 E 3RD STREET
GROVE, OK74344
 Phone: 918-787-7900
 Fax: 918-787-5871
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for LAKEHAVEN DENTAL PC · (Female)

NPI # 1215152608
Status Active
Credentials
Entity Individual
Enumeration date 04/13/2007
Last updated 11/03/2015 - About 11 years ago
Sole proprietor 1 Not specified
Identifiers
  • OK Medicaid 200253590A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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