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Organization
LAKE LEON DENTAL PLLC
Active
Organization
LAKE LEON DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAGHAV PURI BDS, MS (OWNER/DENTIST)
(903) 723-4223
Entity
Organization
Contact information
Practice address
1414 E MAIN ST, EASTLAND, TX 76448-3023
(361) 446-6396
Mailing address
1414 E MAIN ST, EASTLAND, TX 76448-3023
(361) 446-6396
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/10/2026
Last updated
06/10/2026
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