CUSTOM DENTAL OF BONHAM PLLC; NPI #1437795093

Contact Information

CUSTOM DENTAL OF BONHAM PLLC

2016 STATE HIGHWAY 121 N
BONHAM, TX 75418

Phone: 903-227-6576
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Dental	261QD0000X

Indicates primary specialty

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NPI Profile & details for CUSTOM DENTAL OF BONHAM PLLC

NPI #	`1437795093`
LBN Legal business name	CUSTOM DENTAL OF BONHAM PLLC
Authorized official	BRYCE GATES - (DENTIST)
Entity	Organization
Organization subpart ¹	No
Enumeration date	11/19/2019
Last updated	09/08/2021 - About 5 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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