| NPI | 1821472507 |
|---|---|
| Doing Business As | LAKE JACKSON MODERN DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | JOHN S BARNES Owner Doctor 979-583-6005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2015-07-13 |