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General NPI Number Information
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NPI Number | 1043884810
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Entity Type | Organization
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Legal Business Name | LALANI SQUARED LLC
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Dates
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Enumeration Date | 05/17/2021
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Last Update Date | 05/17/2021
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Provider Practice Location Address
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Address Line | 2585 FAITHON P LUCAS SR BLVD STE 100
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City | MESQUITE
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State | TX
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Zip | 75181-1504
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Country | US
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Telephone | 469-730-0090
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Fax |
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Provider Business Mailing Address
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Address Line | 4539 LAFAYETTE ST
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City | DALLAS
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State | TX
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Zip | 75204-4628
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | DR. KHURRAM LALANI
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Credential | DDS
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Telephone | 469-730-0090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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