National Provider Identifier Database

CUSTOM DENTAL OF BONHAM PLLC
Dental


Contact Information

CUSTOM DENTAL OF BONHAM PLLC
2016 STATE HIGHWAY 121 N
BONHAM, TX75418
Phone: 903-227-6576
Fax:
Website:
Specialty Taxonomy Code
* Dental 261QD0000X

* Indicates primary specialty

NPI Profile & details for CUSTOM DENTAL OF BONHAM PLLC

NPI Number 1437795093
Legal business name
LBN
CUSTOM DENTAL OF BONHAM PLLC
Authorized official BRYCE GATES - (DENTIST)
Entity Organization
Organization subpart No
Enumeration date 11/19/2019
Last updated 09/08/2021 - About 5 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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