Lake Dentistry, Llc

LBN: Lake Dentistry, Llc
Lake Dentistry, Llc is an health care organization with primary practice located at 735 Raysor Drive , St. Matthews SC 29135. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Lake Dentistry, Llc can be contacted via phone (803) 874-2243, or through Lake, Clarence R via phone (803) 874-2243.

Contact Information

Primary practice address
735 Raysor Drive St. Matthews SC 29135
Phone: (803) 874-2243
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Lake, Clarence R Doctor of Dental Medicine (DMD)
Phone: (803) 874-2243

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X South Carolina

Profile Details

NPI number 1376608992
LBN Legal business name Lake Dentistry, Llc
DBA Doing business as
Authorized official Lake, Clarence R Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 26th, 2006
Last updated Jan 10th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376608992 NPPES
South Carolina MEDICAID ZA9868

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