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Contact Information

LAKE SHORE DENTAL GROUP PLLC
4535 LAKE SHORE DR
WACO, TX76710
 Phone: 254-776-7622
 Fax: 254-776-7673
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for LAKE SHORE DENTAL GROUP PLLC · (Female)

NPI Number 1093487555
Status Active
Credentials
Entity Individual
Enumeration date 10/04/2021
Last updated 10/04/2021 - About 5 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
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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