Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 29964 | TX |
N | 122300000X | Dentist | D10841 | OR |
N | 1223G0001X | General Practice | 29964 | TX |
N | 213EG0000X | General Practice | 29964 | TX |
Y | 1223P0221X | Pediatric Dentist | D10841 | OR |
NPI | 1003229311 |
---|---|
Provider Name | Sheala Lansden |
First Address | Palestine, TX 75801-5320 |
Second Address | Palestine, TX 75801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2014 |
Last Update Date | 09/02/2021 |