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Organization
RAY DENTAL HOLDINGS PLLC.
Active
Organization
RAY DENTAL HOLDINGS PLLC.
Active
Other names
Lakeline Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
SHIPRA GUPTA DDS (MANAGING MEMBER)
(312) 607-1103
Entity
Organization
Contact information
Practice address
1201 N LAKELINE BLVD STE 300, CEDAR PARK, TX 78613-6780
(312) 607-1103
Mailing address
1201 N LAKELINE BLVD STE 300, CEDAR PARK, TX 78613-6780
(512) 456-7583
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
06/11/2025
Last updated
09/21/2025
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