DR. Edward William Lake, DDS

NPI #1790820587 in Potosi, Missouri

Provider Information

NPI Number: 1790820587
Entity Type: Individual
Name: DR. Edward William Lake, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Feb 20, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 313 E HIGH ST
City: Potosi
State: Missouri
ZIP Code: 63664-1924
Phone: (573) 438-6277

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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