Lakeland Family Dental, LLC

NPI #1518418243 in Oconomowoc, Wisconsin

Provider Information

NPI Number: 1518418243
Entity Type: Organization
Organization Name: Lakeland Family Dental, LLC
Primary Specialty: Dentist
Enumeration Date: Oct 18, 2016
Last Updated: Oct 18, 2016

Practice Location

Address: 1300 N SUMMIT AVE
Address 2: SUITE 101
City: Oconomowoc
State: Wisconsin
ZIP Code: 53066-4467
Phone: (262) 567-1323

Authorized Official

Name: DR. SAMANTHA JEAN RUIZ, DDS
Title: OWNER
Phone: (262) 705-9076

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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