Organization
ALLURE DENTAL OF GRAPEVINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCUS LASTIMADO DMD (DENTIST)
(972) 355-8688
Entity
Organization
Contact information
Practice address
2805 E GRAPEVINE MILLS CIR, SUITE 180, GRAPEVINE, TX 76051-1210
(972) 355-8688
Mailing address
2805 E GRAPEVINE MILLS CIR, SUITE 180, GRAPEVINE, TX 76051-1210
(972) 355-8688
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
23570
TX
Other
Enumeration date
11/29/2012
Last updated
11/29/2012
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