| Gbcc Dental Pllc | |
|
1104 Bluebonnet St Glen Rose TX 76043 | |
| (254) 898-4646 | |
| (254) 897-7321 |
| Full Name | Gbcc Dental Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1104 Bluebonnet St, Glen Rose, Texas |
| Authorized Official Name and Position | Clayton K Cook (OWNER/DENTIST) |
| Authorized Official Contact | 8172941090 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gbcc Dental Pllc 1104 Bluebonnet St Glen Rose TX 76043 Ph: (254) 898-4646 | Gbcc Dental Pllc 1104 Bluebonnet St Glen Rose TX 76043 Ph: (254) 898-4646 |
| NPI Number | 1407397144 |
|---|---|
| Provider Enumeration Date | 03/14/2017 |
| Last Update Date | 09/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407397144 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 29154 (Texas) | Primary |
Gbcc Dental Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 Spanish Oaks Trail, Glen Rose, TX 76043 Phone: 254-897-3143 Fax: 903-465-1134 |