Organization
LEISA ROBOTHAM-REID PLLC
Active
Other names
Lakewood Dental Studio
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEISA ROBOTHAM-REID DDS (MANAGING MEMBER)
(917) 873-2500
Entity
Organization
Contact information
Practice address
6220 GASTON AVE STE 600, DALLAS, TX 75214-4345
(917) 873-2500
Mailing address
4419 CABELL DR APT 102, DALLAS, TX 75204-0001
(917) 873-2500
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/17/2021
Last updated
08/17/2021
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