Mark Lake, D.D.S

NPI 1356479539 · on the registry since 2007 · sole proprietor

Practice

Address: 1037 Palisades Blvd
Ste 9
Osage Beach, MO 65065
Phone: (573) 348-9888
Fax: (573) 348-9894
Organisation at this address: Lake Family Dentistry
Advanced Radiology Llc
Onsite Rehabilitation, Pc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 2

Registry record

Primary taxonomy: 1223G0001X
1223G0001X
Licence states on file: MO
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2007-07-08

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