Lakewood Family Dental of Kokomo Pllc

NPI #1346738556 in Kokomo, Indiana

Provider Information

NPI Number: 1346738556
Entity Type: Organization
Organization Name: Lakewood Family Dental of Kokomo Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Apr 24, 2018
Last Updated: Apr 24, 2018

Practice Location

Address: 2302 S DIXON RD STE 125
City: Kokomo
State: Indiana
ZIP Code: 46902-6429
Phone: (732) 379-0953

Authorized Official

Name: DR. SRINIVASULU KAKOLLU, DDS
Title: PRESIDENT
Phone: (732) 379-0953

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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