| NPI | 1487080404 |
|---|---|
| Doing Business As | LAVENDER DENTAL |
| Entity Type | Organization |
| Authorized Contact | SHANEKA MARKS MOSS Owner 972-352-6677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 25693) |
| Enumeration Date | 2013-09-23 |
| Last Update Date | 2013-09-23 |