Lake, John Campbell
Lake, John Campbell is an sole proprietor health care provider with primary practice located at 2706 Main St , Newberry SC 29108-4004. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Lake, John Campbell can be contacted via phone (803) 276-2090.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 4593 | South Carolina |
Profile Details
| NPI number | 1215263017 |
|---|---|
| LBN Legal business name | Lake, John Campbell |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 29th, 2009 |
| Last updated | Apr 18th, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215263017 | NPPES |
| South Carolina | MEDICAID | ZX4593 |
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