| Lakeside Dental Llc | |
|
15775 Highway 16 E Shirley AR 72153-8930 | |
| (501) 499-0906 | |
| Not Available |
| Full Name | Lakeside Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 15775 Highway 16 E, Shirley, Arkansas |
| Authorized Official Name and Position | Larhonda Apata (DENTIST) |
| Authorized Official Contact | 5014990906 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeside Dental Llc 15775 Highway 16 E Shirley AR 72153-8930 Ph: (501) 499-0906 | Lakeside Dental Llc 15775 Highway 16 E Shirley AR 72153-8930 Ph: (501) 499-0906 |
| NPI Number | 1003268608 |
|---|---|
| Provider Enumeration Date | 07/07/2016 |
| Last Update Date | 07/07/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003268608 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4091 (Arkansas) | Primary |