| Custom Dental of Bonham PLLC | |
|
2016 State Highway 121 N Bonham TX 75418 | |
| (903) 227-6576 | |
| Not Available |
| Full Name | Custom Dental of Bonham PLLC |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2016 State Highway 121 N, Bonham, Texas |
| Authorized Official Name and Position | Bryce Gates (DENTIST) |
| Authorized Official Contact | 4052276100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Custom Dental of Bonham PLLC 2016 N State Highway 121 Bonham TX 75418-2339 Ph: (214) 616-1574 | Custom Dental of Bonham PLLC 2016 State Highway 121 N Bonham TX 75418 Ph: (903) 227-6576 |
| NPI Number | 1437795093 |
|---|---|
| Provider Enumeration Date | 11/19/2019 |
| Last Update Date | 09/08/2021 |
| Certification Date | 09/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437795093 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | () | Primary |
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