Kevin Joseph Lake DMD

NPI 1083638399 - Dentist - 122300000X

NPI Details
NPI 1083638399
Gender Male
Enumeration Date 07/27/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
5 ETHAN DR
NEW PROVIDENCE NJ, 07974-1604, US
Phone (908) 464-5270
Fax
Business Location
5 ETHAN DR
NEW PROVIDENCE NJ, 07974-1604, US
Phone (908) 464-5270
Fax
Toxanomy
Taxonomy Code 122300000X
License State New Jersey
License Number 22DI02044100
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According to our database, Dr. Kevin Joseph Lake DMD NPI is 1083638399, taxonomy code is 122300000X and license number is 22DI02044100, license state is located at New Jersey. Kevin Joseph Lake DMD physically located at 5 Ethan Dr, New Providence NJ, 07974-1604. NPI Number Kevin Joseph Lake DMD has the Individual type.

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1083638399 NPI number is provided on an as is basis without warranty of any kind. 1083638399 is maintained by the National Plan & Provider Enumeration System. The contents of Kevin Joseph Lake DMD are for informational purposes only.