Provider First Line Business Practice Location Address:
LAKESIDE DENTURE STUDIO
Provider Second Line Business Practice Location Address:
6420 HWY 93 SOUTH
Provider Business Practice Location Address City Name:
LAKESIDE
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59922-0728
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-857-3711
Provider Business Practice Location Address Fax Number:
406-857-3712
Provider Enumeration Date:
05/10/2007