Lakeside Family Dentistry and Tmj, PC

NPI #1396825667 in Columbus, Georgia

Provider Information

NPI Number: 1396825667
Entity Type: Organization
Organization Name: Lakeside Family Dentistry and Tmj, PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 17, 2006
Last Updated: Sep 11, 2024

Practice Location

Address: 7270 N LAKE DR STE 100
City: Columbus
State: Georgia
ZIP Code: 31909-2764
Phone: (706) 323-6491

Authorized Official

Name: DR. PHILLIP SHELBY TULLY III, DMD
Title: PRESIDENT
Phone: (706) 323-6491

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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