Organization
LAKESIDE CHILDRENS DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW MORONI HEATON D.D.S. (MEMBER)
(254) 698-0641
Entity
Organization
Contact information
Practice address
103 US HIGHWAY 281, MARBLE FALLS, TX 78654-5701
(830) 693-4770
(830) 693-4773
Mailing address
103 N US HIGHWAY 281, MARBLE FALLS, TX 78654-5701
(830) 693-4770
(830) 693-4773
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
27068
TX
Other
Enumeration date
03/15/2016
Last updated
10/31/2022
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