DR. Terry L Lake, D.M.D.
NPI #1174529903 in South Charleston, West Virginia
Provider Information
- NPI Number
- 1174529903
- Entity Type
- Individual
- Name
- DR. Terry L Lake, D.M.D.
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist - General Practice
- Credential
- D.M.D.
- Enumeration Date
- Jun 27, 2005
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 5001 MACCORKLE AVE SW
- City
- South Charleston
- State
- West Virginia
- ZIP Code
- 25309-1217
- Phone
- (304) 768-5721
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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