| NPI | 1740986256 |
|---|---|
| Doing Business As | LAKESIDE FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | JENNY GARCIA Credentialing Sr Team Lead 972-869-3789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-02-06 |
| Last Update Date | 2023-02-06 |