NPI | 1093252611 |
---|---|
Doing Business As | BASTROP MODERN DENTISTRY |
Entity Type | Organization |
Authorized Contact | JOHN S BARNES Owner Dentist 512-240-6496 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Enumeration Date | 2017-01-20 |
Last Update Date | 2017-01-20 |