Lake Country Orthodontics

NPI #1962013813 in Ardmore, Oklahoma

Provider Information

NPI Number: 1962013813
Entity Type: Organization
Organization Name: Lake Country Orthodontics
Primary Specialty: Dentist - Orthodontics and Dentofacial Orthopedics
Enumeration Date: Aug 13, 2020
Last Updated: Aug 13, 2020

Practice Location

Address: 1119 WALNUT DR STE 4
City: Ardmore
State: Oklahoma
ZIP Code: 73401-2360
Phone: (580) 226-2331

Authorized Official

Name: MRS. LORI A MILLER
Title: OFFICE MANAGER
Phone: (580) 226-2331

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X	Primary

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