| Jasper Dental Emporium | |
|
3303 Recreational Road 255 West Brookeland TX 75931 | |
| (409) 698-8800 | |
| (409) 698-8801 |
| Full Name | Jasper Dental Emporium |
|---|---|
| Speciality | Dentist |
| Location | 3303 Recreational Road 255 West, Brookeland, Texas |
| Authorized Official Name and Position | John Joshua Seale (OWNER/DENTIST) |
| Authorized Official Contact | 4096988800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jasper Dental Emporium 3303 Recreational Road 255 West Brookeland TX 75931 Ph: (409) 698-8800 | Jasper Dental Emporium 3303 Recreational Road 255 West Brookeland TX 75931 Ph: (409) 698-8800 |
| NPI Number | 1760939888 |
|---|---|
| Provider Enumeration Date | 09/07/2016 |
| Last Update Date | 09/07/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760939888 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 15204 (Texas) | Secondary |
| 122300000X | Dentist | 22917 (Texas) | Primary |
Jasper Dental Emporium Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3303 W Rr 255, Brookeland, TX 75931 Phone: 409-698-8800 |