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Organization
LAKE SHORE DENTAL GROUP PLLC
Active
Organization
LAKE SHORE DENTAL GROUP PLLC
Active
Parent organization
BRIGHT DENTAL ASSOCIATES LLC
Other names
Bright Dental Associates LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BRIGHT DENTAL ASSOCIATES LLC
Authorized official
TRACI WALDSCHMIDT (CHIEF OPERATING OFFICER)
(254) 722-1083
Entity
Organization
Contact information
Practice address
4535 LAKE SHORE DR, WACO, TX 76710
(254) 776-7622
(254) 776-7673
Mailing address
4535 LAKE SHORE DR, WACO, TX 76710-1814
(254) 776-7622
(254) 776-7673
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/04/2021
Last updated
10/04/2021
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