EDWARD WILLIAM LAKE DDS PC NPI 1063676369

NPI Information

  • NPI: 1063676369
  • Provider Name: EDWARD WILLIAM LAKE DDS PC
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Address: 313 E HIGH ST
    POTOSI, MO
    ZIP 63664
  • Phone: (573) 438-6277

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NPI Details

EDWARD WILLIAM LAKE DDS PC is a dental clinic center in Potosi, MO. EDWARD WILLIAM LAKE DDS PC NPI is 1063676369. The provider is registered as an organization entity type.

The provider's business location address is:

313 E HIGH ST
POTOSI, MO
ZIP 63664-924
Phone: (573) 438-6277

The provider's authorized official is Edward William Lake .
The authorized official title is President and has the following contact phone number (573) 438-6277.

The enumeration date for this NPI number is 7/16/2008 and was last updated on 7/16/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QD0000XClinic/CenterDental11627MISSOURIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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