Terry L Lake in South Charleston - General Practice
Terry L Lake - NPI 1174529903
Terry L Lake is a General Practice in South Charleston, . Terry L Lake practices all healthcare services and medical treatments related to General Practice. The NPI Number for Terry L Lake is 1174529903. The last update date is 2007-07-08.
Terry L Lake's current location address is 5001 Maccorkle Ave Sw, South Charleston, . You can contact this provider via phone number 3047685721 and fax number 3047686131. The mailing address for Terry L Lake is 5001 Maccorkle Ave Sw, South Charleston, . To know further, please read the information below!
Provider Profile Detail
| Provider Name | Terry L Lake |
|---|---|
| Address | 5001 Maccorkle Ave Sw, South Charleston, |
| Phone Number | 3047685721 |
| Fax Number | 3047686131 |
| Sole Proprietor | N |
| Credentials | D.M.D. |
NPI Number Detail
| NPI Number | 1174529903 |
|---|---|
| Provider Enumeration Date | 2005-06-27 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 5001 Maccorkle Ave Sw |
|---|---|
| City | South Charleston |
| State | (WV) |
| Post Code | 253091217 |
| Phone Number | 3047685721 |
| Fax Number | 3047686131 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 2379WV |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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What is the unique 10-digit identifier code issued to Terry L Lake by the Centers for Medicare & Medicaid Services?
The Terry L Lake has been assigned the NPI (National Provider Identifier) 1174529903 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you share the physical location details of Terry L Lake?
The Terry L Lake is situated at 5001 Maccorkle Ave Sw, in the city of South Charleston, state of WV, with the zip code 253091217.
What is the Terry L Lake's specialty and taxonomy code?
The Terry L Lake's specialty is General Practice, and the corresponding taxonomy code is 1223G0001X.
When did Terry L Lake receive its 1174529903 assignment?
The Terry L Lake was assigned its 1174529903 on 2005-06-27, which is the date when this unique identifier was issued to the organization.
When was the information regarding Terry L Lake most recently updated?
The details pertaining to the Terry L Lake, including its address, specialty, and other relevant information, were last refreshed on 2007-07-08.