NPI: 1184389355
Provider Name: FULL SMILE DENTAL LAKERIDGE, PLLC
Former Legal Business Name: FULL SMILE DENTAL LAKERIDGE, PLLC
Classification: Dentist - 1223S0112X
Entity Type: Organization
Specialization: Oral and Maxillofacial Surgery
Address:
4425 98TH ST
LUBBOCK, TX
ZIP 79424
Phone: (806) 641-1373
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FULL SMILE DENTAL LAKERIDGE, PLLC is an oral and maxillofacial surgery dentist in Lubbock, TX. The provider is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. FULL SMILE DENTAL LAKERIDGE, PLLC NPI is 1184389355. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Full Smile Dental Lakeridge, Pllc.
The provider's business location address is:
4425 98TH ST
LUBBOCK, TX
ZIP 79424-029
Phone: (806) 641-1373
Fax: (806) 353-7077
The provider's authorized official is Jennifer Lynn Morris .
The authorized official title is Credentialing Specialist and has the following contact phone number (806) 353-1055.
The enumeration date for this NPI number is 11/3/2021 and was last updated on 2/24/2022.