Lake Dental Group is a Dental Clinic in Racine, Wisconsin. It is located at 400 Lake Ave, Racine, WI and its contact number is 262-633-0775. The authorized person for Lake Dental Group is Ms. Lilly Poole
who is Office Manager of the clinic and their contact number is 262-633-0775.
Lake Dental Group Clinic have dental surgeons who are specialized in dentistry, diagnosis, prevention, and treatment of diseases and conditions of the oral cavity. The dentist's supporting team aids in providing oral health services. The dental team includes dental assistants, dental hygienists, dental technicians, and sometimes dental therapists.
Complete Clinic Profile:
Lake Dental Group Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Lake Dental Group |
| Specialization: | Dentistry |
| Clinic Address: | 400 Lake Ave, Racine,
Wisconsin, 53403-1020 |
| Phone: | 262-633-0775 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Ms. Lilly Poole |
| Position: | Office Manager |
| Contact Number: | 262-633-0775 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Lake Dental Group clinic are as mentioned below.
| NPI Number: | 1922314210 |
| NPI Enumeration Date: | 24 Aug, 2010 |
| NPI Last Update On: | 24 Aug, 2010 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Lake Dental Group are as mentioned below.
| Specialization | License Number | State | Status | |
| Dentist | | | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 33605400 | Medicaid | Wisconsin | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Lake Dental Group
400 Lake Ave,
Racine, Wisconsin |
| Zip: | 53403-1020 |
| Phone Number: | 262-633-0775 |
Patients can reach Lake Dental Group at
400 Lake Ave, Racine, Wisconsin or can
call to book an appointment on 262-633-0775.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.