OrganizationLakefront Dental PllcDentistDental ProvidersPractice Address95 Beaverfork Rd, Conway, AR 72032-9517(501) 327-6529(501) 650-3717PECOS EnrollmentBased on the most recent information from CMS, provider Lakefront Dental Pllc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:47 AM.Profile DetailsProvider ID1639276603Provider TypeOrganizationFull NameLakefront Dental PllcSubpartNoEnumeration Date9/20/2006Last Updated3/11/2025Contact InformationPractice LocationPractice Address95 Beaverfork Rd, Conway, AR 72032-9517Phone(501) 327-6529Fax(501) 327-8695Mailing LocationMailing Address5665 Tivoli Dr, Conway, AR 72034-8241Phone(501) 650-3717Fax(501) 650-3717Authorized OfficialNameSherwood, Stuart (Dentist Owner)Phone(501) 215-4913Provider TaxonomiesCodeDescriptionLicenseCode1223G0001XPrimaryDescriptionDentistDental ProvidersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID621710579DescriptionOtherIssuerTAX IDArkansas