DR. TERRY LAKE, D.M.D.
Dentist - General Practice
Active
Individual
NPI: 1174529903
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Dentist - General Practice | 1223G0001X | Yes | 2379WV (WV) |
Frequently Asked Questions
NPI 1174529903 is the National Provider Identifier for DR. TERRY LAKE, D.M.D., a Dentist - General Practice provider located in South Charleston, WV. This NPI was enumerated on June 27, 2005.
DR. TERRY LAKE, D.M.D. practices at 5001 MACCORKLE AVE SW, South Charleston, WV 25309.
Quick Facts
- NPI
- 1174529903
- Type
- Individual
- Enumerated
- Jun 27, 2005
- Last Updated
- Jul 8, 2007
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