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General NPI Number Information
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NPI Number | 1497293997
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Entity Type | Organization
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Legal Business Name | SUMMER HILL DENTAL PC
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Dates
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Enumeration Date | 02/03/2017
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 19750 STATE HIGHWAY 46 WEST, SUITE 105
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City | SPRING BRANCH
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State | TX
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Zip | 78070
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Country | US
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Telephone | 830-438-2193
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Fax | 830-438-2196
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Provider Business Mailing Address
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Address Line | 19750 STATE HIGHWAY 46 WEST, SUITE 105
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City | SPRING BRANCH
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State | TX
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Zip | 78070
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Country | US
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Telephone | 830-438-2193
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Fax | 830-438-2196
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MATTHEW WAYNE BAYLESS
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Credential | DDS
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Telephone | 830-438-2193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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