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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

NPI Number 1093487555
LBN Legal business name LAKE SHORE DENTAL GROUP PLLC
Authorized official TRACI WALDSCHMIDT - (CHIEF OPERATING OFFICER)
Entity Organization
Organization subpart 1 Yes
Enumeration date 10/04/2021
Last updated 10/04/2021 - About 5 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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