| NPI | 1134001266 |
|---|---|
| Doing Business As | LAKESIDE DENTAL |
| Entity Type | Organization |
| Authorized Contact | BENJAMIN BACON Doctor/Owner 361-815-9929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2025-07-21 |
| Last Update Date | 2025-07-27 |