Organization
LAKESHORE DENTAL CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASEY CASTLE (DIRECTOR OF PAYOR CONTRACTS)
(912) 732-1504
Entity
Organization
Contact information
Practice address
4695 OLD CANOE CREEK RD, SAINT CLOUD, FL 34769-1550
(407) 957-6760
Mailing address
4695 OLD CANOE CREEK RD, SAINT CLOUD, FL 34769-1550
(407) 957-6760
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/20/2025
Last updated
10/20/2025
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