| Lakeline Mall Family Dental | |
|
11200 Lakeline Mall Dr Suite B01 Cedar Park TX 78613-1501 | |
| (214) 390-9948 | |
| Not Available |
| Full Name | Lakeline Mall Family Dental |
|---|---|
| Speciality | Dentist |
| Location | 11200 Lakeline Mall Dr, Cedar Park, Texas |
| Authorized Official Name and Position | Justin Cordon (MANAGER) |
| Authorized Official Contact | 2143909948 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeline Mall Family Dental 11200 Lakeline Mall Dr Suite B01 Cedar Park TX 78613-1501 Ph: () - | Lakeline Mall Family Dental 11200 Lakeline Mall Dr Suite B01 Cedar Park TX 78613-1501 Ph: (214) 390-9948 |
| NPI Number | 1053753764 |
|---|---|
| Provider Enumeration Date | 07/23/2013 |
| Last Update Date | 07/23/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053753764 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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