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Contact Information

LAKE FAMILY DENTISTRY
1037 PALISADES BLVD STE 9
OSAGE BEACH, MO65065
 Phone: 573-348-9888
 Fax: 573-348-9894
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for LAKE FAMILY DENTISTRY · (Female)

NPI Number 1457514259
Status Active
Credentials
Entity Individual
Enumeration date 07/02/2008
Last updated 07/02/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • MO License # 2006014707
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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