Organization
LAKESHORE DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAIME VILLARREAL D.D.S (DR./OWNER)
(972) 722-9100
Entity
Organization
Contact information
Practice address
3045 N GOLIAD ST, SUITE 105, ROCKWALL, TX 75087-7092
(972) 722-9100
(972) 722-9103
Mailing address
3045 N GOLIAD ST, SUITE 105, ROCKWALL, TX 75087-7092
(972) 722-9100
(972) 722-9103
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
21771
TX
122300000X
Dentist
Primary
22206
TX
Other
Enumeration date
09/16/2013
Last updated
08/28/2015
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