| Lakeview Mobile Dental Services, Pllc | |
|
1505 W Mcdermott Dr Ste 200 Allen TX 75013-4692 | |
| (469) 675-3890 | |
| (469) 675-3893 |
| Full Name | Lakeview Mobile Dental Services, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1505 W Mcdermott Dr, Allen, Texas |
| Authorized Official Name and Position | Reji Mathew (MEMBER) |
| Authorized Official Contact | 4696753890 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeview Mobile Dental Services, Pllc 1505 W Mcdermott Dr Ste 200 Allen TX 75013-4692 Ph: (469) 675-3890 | Lakeview Mobile Dental Services, Pllc 1505 W Mcdermott Dr Ste 200 Allen TX 75013-4692 Ph: (469) 675-3890 |
| NPI Number | 1295132488 |
|---|---|
| Provider Enumeration Date | 12/03/2014 |
| Last Update Date | 12/03/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295132488 | NPI | - | NPPES |
| 23355 | Other | TX | DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 23355 (Texas) | Primary |
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