| NPI | 1093944241 |
|---|---|
| Other Name | LAKELINE MALL DENTAL |
| Entity Type | Organization |
| Authorized Contact | PAUL DABNEY Owner/ Dentist 512-260-0123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 14486) |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2009-07-09 |