Organization
LAKESIDE SMILES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANDON SIMS (OWNER)
(931) 552-2582
Entity
Organization
Contact information
Practice address
107 IMPERIAL BLVD STE 12, HENDERSONVILLE, TN 37075-3441
(615) 824-2013
Mailing address
107 IMPERIAL BLVD STE 12, HENDERSONVILLE, TN 37075-3441
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/17/2023
Last updated
07/17/2023
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