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Organization

LAKEWOOD KIDS DENTISTRY, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DAVETTE D JOHNSON-HARRIS DDS,MS (OWNER,PROVIDER)
(832) 654-6641
Entity
Organization

Contact information

Practice address
11550 LOUETTA RD, HOUSTON, TX 77070-1368
(832) 654-6641
Mailing address
11550 LOUETTA RD, HOUSTON, TX 77070-1368
(832) 654-6641

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1518198480
NPI
TX
Enumeration date
02/13/2019
Last updated
02/13/2019
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