# CYNTHIA OVERHOLSER DDS

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

## Provider details

- **NPI number:** 1134450034
- **Authorized official:** DR. CYNTHIA ANNE OVERHOLSER DDS (DENTIST/OWNER)
- **Authorized official phone:** (979) 297-6438

## Contact information

- **Practice address:** 103 N DIXIE DR, LAKE JACKSON, TX 77566-5940
- **Practice address phone:** (979) 297-6438
- **Practice address fax:** (979) 297-4644
- **Mailing address:** 103 N DIXIE DR, LAKE JACKSON, TX 77566-5940
- **Mailing address phone:** (979) 297-6438
- **Mailing address fax:** (979) 297-4644

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 19245 | TX | Yes |

## Other

- **Enumeration date:** 01/18/2010
- **Last updated:** 01/18/2010