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General NPI Number Information
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NPI Number | 1982055125
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Entity Type | Organization
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Legal Business Name | DR YASO LAKSHMANAKUMARASAMY DDS PA
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Dates
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Enumeration Date | 06/29/2016
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Last Update Date | 06/29/2016
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Provider Practice Location Address
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Address Line | 2440 TIMBER RIDGE DR STE 102
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City | FRISCO
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State | TX
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Zip | 75034-5040
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Country | US
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Telephone | 469-906-2244
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Fax | 469-906-2245
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Provider Business Mailing Address
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Address Line | 2440 TIMBER RIDGE DR STE 102
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City | FRISCO
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State | TX
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Zip | 75034-5040
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Country | US
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Telephone | 469-906-2244
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Fax | 469-906-2245
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Authorized Official
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Title or Position | DENTIST
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Name | DR. YASODHADEVI LAKSHMANAKUMARASAMY
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Credential | DDS
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Telephone | 408-470-8418
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 25241
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License Number State | TX
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