Organization
LAKE JUNE SRGM PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NINA ABTAHI (MANAGER)
(214) 493-1216
Entity
Organization
Contact information
Practice address
10025 LAKE JUNE RD # B, DALLAS, TX 75217-3041
(214) 493-1216
Mailing address
10025 LAKE JUNE RD # B, DALLAS, TX 75217-3041
(214) 493-1216
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
02/24/2021
Last updated
02/24/2021
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