Lakeside Family & Cosmetic Dentistry, LLC

NPI #1740986256 in Tualatin, Oregon

Provider Information

NPI Number: 1740986256
Entity Type: Organization
Organization Name: Lakeside Family & Cosmetic Dentistry, LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Feb 6, 2023
Last Updated: Feb 6, 2023

Practice Location

Address: 8225 SW TUALATIN SHERWOOD RD
City: Tualatin
State: Oregon
ZIP Code: 97062-8441
Phone: (503) 692-9386

Authorized Official

Name: JENNY GARCIA
Title: CREDENTIALING SR TEAM LEAD
Phone: (972) 869-3789

Specialties & Taxonomy Codes

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

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