# KO DENTAL GROUP, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dynamic Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053911396
- **Authorized official:** LYNDA MARLIESSA CLARK (AM)
- **Authorized official phone:** (254) 784-0508

## Contact information

- **Practice address:** 302 S. AVENUE Q, CLIFTON, TX 76634
- **Practice address phone:** (254) 675-3518
- **Practice address fax:** (254) 675-1262
- **Mailing address:** 302 S. AVENUE Q, CLIFTON, TX 76634
- **Mailing address phone:** (254) 675-3518
- **Mailing address fax:** (254) 675-1262

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 10/27/2020
- **Last updated:** 07/21/2022