Provider Demographics
NPI:1598034829
Name:LAKEPOINTE ORTHODONTICS PLLC
Entity Type:Organization
Organization Name:LAKEPOINTE ORTHODONTICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:KRIEG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:586-772-6090
Mailing Address - Street 1:22006 GREATER MACK AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-2307
Mailing Address - Country:US
Mailing Address - Phone:586-772-6090
Mailing Address - Fax:586-772-0621
Practice Address - Street 1:22006 GREATER MACK AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-2307
Practice Address - Country:US
Practice Address - Phone:586-772-6090
Practice Address - Fax:586-772-0621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-15
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty