Lakeshore Pediatric Dentistry Pllc | |
2993 Main St Ste 2 Peru NY 12972-2927 | |
(518) 282-5519 | |
Not Available |
Full Name | Lakeshore Pediatric Dentistry Pllc |
---|---|
Speciality | Dentist - Pediatric Dentistry |
Location | 2993 Main St Ste 2, Peru, New York |
Authorized Official Name and Position | Colleen Marie Lacombe-senecal (PEDIATRIC DENTIST/OWNER) |
Authorized Official Contact | 5185785295 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Lakeshore Pediatric Dentistry Pllc 2993 Main St Ste 2 Peru NY 12972-2927 Ph: (518) 282-5519 | Lakeshore Pediatric Dentistry Pllc 2993 Main St Ste 2 Peru NY 12972-2927 Ph: (518) 282-5519 |
NPI Number | 1114586625 |
---|---|
Provider Enumeration Date | 06/08/2019 |
Last Update Date | 06/08/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114586625 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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