Cordell Lake, DDS
NPI 1255744405 · on the registry since 2014 · sole proprietor
Practice
- Address
- 12 E Harrison St
Farmington, MO 63640 - Phone
- (573) 756-4344
- Organisation at this address
- Cordell Lake, D.D.S., Llc
Timothy M. O'Bryan Dds, LlcInferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- Dentist
122300000X
- Licence states on file
- MO
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2019-03-04
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Missouri