Ruby J Lake
Dentist in Frederiksted, VI. Individual provider (NPI-1).
NPI number1487907192
StatusActive
Last updated in NPPESOct 18, 2012
Details
- NPI
- 1487907192
- Entity type
- Individual (NPI-1)
- Name
- Ruby J Lake
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 18, 2012
- Last updated
- Oct 18, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 708 | VI | Yes |
Practice location
16 Strand StreetFrederiksted, VI 00840
Phone 340-772-1616 · Fax 340-772-1616
Mailing address
414 Strand StreetFrederiksted, VI 00840
Phone 340-772-1616 · Fax 340-772-1616
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