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General NPI Number Information
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NPI Number | 1366785826
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Entity Type | Organization
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Legal Business Name | BEE COUNTRY MODERN DENTISTRY AND ORTHODONTICS, PC
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Dates
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Enumeration Date | 04/03/2013
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Last Update Date | 07/29/2013
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Provider Practice Location Address
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Address Line | 4005 MARKET STREET SUITE 150
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City | BEE CAVE
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State | TX
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Zip | 78738
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Country | US
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Telephone | 512-263-4142
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Fax | 512-263-4353
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Provider Business Mailing Address
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Address Line | 17000 RED HILL AVE
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City | IRVINE
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State | CA
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Zip | 92614-5626
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Country | US
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Telephone | 714-845-8890
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Fax | 949-474-1495
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Authorized Official
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Title or Position | OWNER DOCTOR
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Name | DR. JOHN S BARNES
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Credential | DDS
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Telephone | 512-263-4142
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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