# LAKES DENTAL FW PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306555032
- **Authorized official:** CECILE NGUYEN (OWNER)
- **Authorized official phone:** (972) 896-9386

## Contact information

- **Practice address:** 4968 OVERTON RIDGE BLVD, FORT WORTH, TX 76132-1909
- **Practice address phone:** (817) 263-0181
- **Mailing address:** 5729 LEBANON RD STE 144268, FRISCO, TX 75034-7260

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 11/21/2022
- **Last updated:** 12/15/2022