Ruby J Lake

NPI #1487907192 in Frederiksted, Virgin Islands

Provider Information

NPI Number: 1487907192
Entity Type: Individual
Name: Ruby J Lake
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Enumeration Date: Oct 18, 2012
Last Updated: Oct 18, 2012

Practice Location

Address: 16 STRAND STREET
City: Frederiksted
State: Virgin Islands
ZIP Code: 00840
Phone: (340) 772-1616

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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