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Organization
LANTANA FAMILY DENTISTRY, PA
Active
Organization
LANTANA FAMILY DENTISTRY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLIE K CLEVELAND DDS (OWNER/PRESIDENT)
(940) 455-7004
Entity
Organization
Contact information
Practice address
4110 FM 407, SUITE 150, LEWISVILLE, TX 75077-7269
(940) 455-7004
(940) 455-7064
Mailing address
4110 FM 407, SUITE 150, LEWISVILLE, TX 75077-7269
(940) 455-7004
(940) 455-7064
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21699
TX
Other
Enumeration date
11/22/2011
Last updated
11/22/2011
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