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Contact Information

LAKESIDE DENTAL LLC
15775 HIGHWAY 16 E
SHIRLEY, AR72153
 Phone: 501-723-8113
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for LAKESIDE DENTAL LLC · (Female)

NPI # 1003268608
Status Active
Credentials
Entity Individual
Enumeration date 07/07/2016
Last updated 07/07/2016 - About 10 years ago
Sole proprietor 1 Not specified
Identifiers
  • AR License # 4091
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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