Lakeside Dental

NPI #1558462689 in Little Elm, Texas

Provider Information

NPI Number: 1558462689
Entity Type: Organization
Organization Name: Lakeside Dental
Primary Specialty: Dentist
Enumeration Date: Sep 25, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 407 W ELDORADO PKWY STE 140
City: Little Elm
State: Texas
ZIP Code: 75068-5086
Phone: (972) 292-3092

Authorized Official

Name: VANPHAPHONE LINAVONG
Title: DENTIST
Phone: (972) 929-3092

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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