| NPI | 1134450034 |
|---|---|
| Doing Business As | LAKE JACKSON FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | CYNTHIA ANNE OVERHOLSER Dentist/Owner 979-297-6438 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 19245) |
| Enumeration Date | 2010-01-18 |
| Last Update Date | 2010-01-18 |