Organization
LAKESIDE FAMILY & COSMETIC DENTISTRY, LLC
Active
Other names
Lakeside Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY GARCIA (CREDENTIALING SR TEAM LEAD)
(972) 869-3789
Entity
Organization
Contact information
Practice address
8225 SW TUALATIN SHERWOOD RD, TUALATIN, OR 97062-8441
(503) 692-9386
(503) 612-9437
Mailing address
8225 SW TUALATIN SHERWOOD RD, TUALATIN, OR 97062-8441
(503) 692-9386
(503) 612-9437
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/06/2023
Last updated
02/06/2023
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