Lakeline Family Dental

NPI #1043612963 in Cedar Park, Texas

Provider Information

NPI Number: 1043612963
Entity Type: Organization
Organization Name: Lakeline Family Dental
Primary Specialty: Dentist
Enumeration Date: Sep 23, 2014
Last Updated: Sep 23, 2014

Practice Location

Address: 1201 N LAKELINE BLVD
Address 2: SUITE NUMBER 300
City: Cedar Park
State: Texas
ZIP Code: 78613-6781
Phone: (512) 937-3371

Authorized Official

Name: DR. AMITA PRAKASH, DDS
Title: DENTIST
Phone: (512) 659-6968

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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