Organization
RAY DENTAL HOLDINGS PLLC.
Active
Other names
Lakeline Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
SHIPRA GUPTA DDS (MANAGING MEMBER)
(312) 607-1103
Entity
Organization
Contact information
Practice address
1201 N LAKELINE BLVD STE 300, CEDAR PARK, TX 78613-6780
(312) 607-1103
Mailing address
1201 N LAKELINE BLVD STE 300, CEDAR PARK, TX 78613-6780
(512) 456-7583
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/11/2025
Last updated
09/21/2025
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