# LAKEWOOD DENTAL ASSOCIATES, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760723381
- **Authorized official:** JEFFREY CLARK D.M.D. (OWNER/DENTIST)
- **Authorized official phone:** (936) 689-6544

## Contact information

- **Practice address:** 901 NORMAL PARK DR, SUITE 200, HUNTSVILLE, TX 77320-3770
- **Practice address phone:** (936) 689-6544
- **Mailing address:** 901 NORMAL PARK DR, SUITE 200, HUNTSVILLE, TX 77320-3770
- **Mailing address phone:** (936) 689-6544

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | — |
| 1223G0001X | General Practice Dentistry | — | — | — |
| 261QD0000X | Dental Clinic/Center | 27909 | TX | Yes |

## Other

- **Enumeration date:** 03/06/2013
- **Last updated:** 02/14/2024