Organization · Type 2 NPI

Full Smile Dental Lakeridge, PLLC

Oral and Maxillofacial Surgery (Dentist) · Lubbock, TX

NPI number 1184389355 Active

Practice location

4425 98th St
Lubbock, TX 79424-5029

Call (806) 641-1373 Map

Fax (806) 353-7077

Mailing address

5051 S Soncy Rd
Amarillo, TX 79119-6667

Specialties and licenses

Taxonomy	Code	License
Endodontics	1223E0200X	None listed
Oral and Maxillofacial Surgery (Dentist) Primary	1223S0112X	None listed
Orthodontics and Dentofacial Orthopedics Dentistry	1223X0400X	None listed

Oral and Maxillofacial Surgery (Dentist): 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.

4 other providers at this address

Other oral and maxillofacial surgery (dentist) providers in Lubbock

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NPI record

NPI: 1184389355
Entity type: Organization (Type 2)
Issued: Nov 3, 2021
Last updated: Feb 24, 2022
Status: Active

Other names

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Full Smile Dental Lakeridge, PLLC · former legal business name
Full Smile Dental Lakeridge, PLLC · former legal business name

Authorized official

Jennifer Lynn Morris
Credentialing Specialist
(806) 353-1055

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1184389355

Full Smile Dental Lakeridge, PLLC's National Provider Identifier is 1184389355, issued on Nov 3, 2021. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Lubbock, TX. The record was last updated on Feb 24, 2022.