R L Lake DDS INC

NPI #1669585402 in Talihina, Oklahoma

Provider Information

NPI Number: 1669585402
Entity Type: Organization
Organization Name: R L Lake DDS INC
Primary Specialty: Dentist
Enumeration Date: Aug 16, 2006
Last Updated: Sep 19, 2007

Practice Location

Address: 200 DALLAS ST
City: Talihina
State: Oklahoma
ZIP Code: 74571-2402
Phone: (918) 567-3961

Authorized Official

Name: DR. RAMON L LAKE JR., DDS
Title: PRESIDENT R L LAKE DDS INC
Phone: (918) 567-3961

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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