Organization
LAKELINE MALL FDC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN ARMSTRONG (REGIONAL MANAGER)
(505) 328-4857
Entity
Organization
Contact information
Practice address
11200 LAKELINE MALL DR, STE B1, CEDAR PARK, TX 78613-1502
(512) 448-4867
(512) 335-7668
Mailing address
11200 LAKELINE MALL DR, STE B1, CEDAR PARK, TX 78613-1502
(512) 448-4867
(512) 335-7668
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0008481
TX
Other
Enumeration date
05/23/2008
Last updated
05/23/2008
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