Lakeshore Dental Pllc | |
3045 N Goliad St Suite 105 Rockwall TX 75087-7092 | |
(972) 722-9100 | |
(972) 722-9103 |
Full Name | Lakeshore Dental Pllc |
---|---|
Speciality | Dentist |
Location | 3045 N Goliad St, Rockwall, Texas |
Authorized Official Name and Position | Jaime Villarreal (DR./OWNER) |
Authorized Official Contact | 9727229100 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Lakeshore Dental Pllc 3045 N Goliad St Suite 105 Rockwall TX 75087-7092 Ph: (972) 722-9100 | Lakeshore Dental Pllc 3045 N Goliad St Suite 105 Rockwall TX 75087-7092 Ph: (972) 722-9100 |
NPI Number | 1457787970 |
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Provider Enumeration Date | 09/16/2013 |
Last Update Date | 08/28/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1457787970 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 22206 (Texas) | Primary |
122300000X | Dentist | 21771 (Texas) | Secondary |
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