| Lake Cities Pediatric Dentistry and Orthodontics | |
|
3502 Corinth Pkwy # 400 Corinth TX 76208-5481 | |
| (214) 455-4487 | |
| Not Available |
| Full Name | Lake Cities Pediatric Dentistry and Orthodontics |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 3502 Corinth Pkwy # 400, Corinth, Texas |
| Authorized Official Name and Position | Albert Yamoah (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 2144554487 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Cities Pediatric Dentistry and Orthodontics 2904 Groveland Ct Denton TX 76210-0587 Ph: (214) 455-4487 | Lake Cities Pediatric Dentistry and Orthodontics 3502 Corinth Pkwy # 400 Corinth TX 76208-5481 Ph: (214) 455-4487 |
| NPI Number | 1316573009 |
|---|---|
| Provider Enumeration Date | 03/13/2020 |
| Last Update Date | 11/02/2022 |
| Certification Date | 11/02/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316573009 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | () | Secondary |
| 1223P0221X | Dentist - Pediatric Dentistry | () | Primary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | () | Secondary |
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