SOUTHLAKE DENTAL CORP

Dentist - Periodontics

Active Organization
NPI: 1154544740

Practice Address

1124 S LAKE STREET
SUITE B
Fort Worth, TX 76104

Phone: (817) 336-1166

Specialties

Specialty Code Primary License
Dentist - Periodontics 1223P0300X Yes 9930 (TX)

Frequently Asked Questions

NPI 1154544740 is the National Provider Identifier for SOUTHLAKE DENTAL CORP, a Dentist - Periodontics provider located in Fort Worth, TX. This NPI was enumerated on April 11, 2007.

Quick Facts

NPI
1154544740
Type
Organization
Enumerated
Apr 11, 2007
Last Updated
Aug 22, 2020

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