MEDICARE: HOUSTON DENTISTRY PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1932421021
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSTON DENTISTRY PC

Provider Business Mailing Address
First Line	:	2860 MICHELLE FL 2
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92606-1008
Country	:	US
Telephone Number	:	714-368-2084
Fax Number	:

Provider Business Practice Location Address
First Line	:	6808 HARRISBURG BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77011-4626
Country	:	US
Telephone Number	:	713-928-6600
Fax Number	:	713-583-7571

Authorized Official
Title or Position	:	OWNER DOCTOR
Name	:	DR. JOHN S BARNES
Credential	:	DDS
Telephone Number	:	713-928-6600

Provider Enumeration Date	:	02/17/2010
Last Update Date	:	02/17/2010

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