| NPI | 1407509227 |
|---|---|
| Doing Business As | FOREST FAMILY DENTISTRY EASTSIDE |
| Entity Type | Organization |
| Authorized Contact | LANA EADS Billing Lead 512-761-2223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-02-01 |
| Last Update Date | 2022-02-01 |