| Bright Dental Studio Pllc | |
|
120 W Columbia St San Augustine TX 75972-1904 | |
| (936) 288-3520 | |
| (936) 288-5076 |
| Full Name | Bright Dental Studio Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 120 W Columbia St, San Augustine, Texas |
| Authorized Official Name and Position | Sidney J Fowler (OWNER) |
| Authorized Official Contact | 9365649401 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bright Dental Studio Pllc 120 W Columbia St San Augustine TX 75972-1904 Ph: (936) 288-3520 | Bright Dental Studio Pllc 120 W Columbia St San Augustine TX 75972-1904 Ph: (936) 288-3520 |
| NPI Number | 1184340622 |
|---|---|
| Provider Enumeration Date | 10/17/2022 |
| Last Update Date | 10/31/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184340622 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| 261QS0112X | Clinic/center - Oral And Maxillofacial Surgery | (* (Not Available)) | Secondary |
Jeannine Cullum Dds, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 214 E Main St, San Augustine, TX 75972 Phone: 936-275-3101 Fax: 936-275-1551 |