Organization
KO DENTAL GROUP, PC
Active
Other names
Dynamic Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
LYNDA MARLIESSA CLARK (AM)
(254) 784-0508
Entity
Organization
Contact information
Practice address
302 S. AVENUE Q, CLIFTON, TX 76634
(254) 675-3518
(254) 675-1262
Mailing address
302 S. AVENUE Q, CLIFTON, TX 76634
(254) 675-3518
(254) 675-1262
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/27/2020
Last updated
07/21/2022
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