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General NPI Number Information
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NPI Number | 1821426313
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Entity Type | Organization
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Legal Business Name | BRIARGROVE SMILES DENTISTRY, PC
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Dates
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Enumeration Date | 10/22/2013
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Last Update Date | 01/08/2014
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Provider Practice Location Address
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Address Line | 1850 FOUNTAIN VIEW DR
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City | HOUSTON
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State | TX
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Zip | 77057-3004
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Country | US
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Telephone | 713-783-1095
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Fax | 713-783-1250
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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
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Name | JOHN BARNES
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Credential | D.D.S.
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Telephone | 713-783-1095
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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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