Lake Country Dental

NPI #1972692556 in Fort Worth, Texas

Provider Information

NPI Number: 1972692556
Entity Type: Organization
Organization Name: Lake Country Dental
Primary Specialty: Dentist
Enumeration Date: Oct 12, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 8461 BOAT CLUB RD
City: Fort Worth
State: Texas
ZIP Code: 76179-3607
Phone: (817) 236-8771

Authorized Official

Name: DR. RAY D. SNIDER, D.D.S., P.A.
Title: OWNER/DENTIST
Phone: (817) 236-8771

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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