Lakeshore Dental Pllc

NPI #1457787970 in Rockwall, Texas

Provider Information

NPI Number: 1457787970
Entity Type: Organization
Organization Name: Lakeshore Dental Pllc
Primary Specialty: Dentist
Enumeration Date: Sep 16, 2013
Last Updated: Aug 28, 2015

Practice Location

Address: 3045 N GOLIAD ST
Address 2: SUITE 105
City: Rockwall
State: Texas
ZIP Code: 75087-7092
Phone: (972) 722-9100

Authorized Official

Name: DR. JAIME VILLARREAL, D.D.S
Title: DR./OWNER
Phone: (972) 722-9100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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