Lakeside Dental LLC
NPI #1891262804 in Manchester, Maine
Provider Information
- NPI Number
- 1891262804
- Entity Type
- Organization
- Organization Name
- Lakeside Dental LLC
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Oct 29, 2018
- Last Updated
- Oct 29, 2018
Practice Location
- Address
- 1051 WESTERN AVE
- City
- Manchester
- State
- Maine
- ZIP Code
- 04351-3403
- Phone
- (207) 310-0842
Authorized Official
- Name
- DR. RYAN SALAMON, DMD
- Title
- MANAGER
- Phone
- (207) 310-0842
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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