Bluebonnet Dental Care

NPI 1033496716 - Dentist - 1223G0001X

NPI Details
NPI 1033496716
Enumeration Date 11/09/2011
Last Updated 11/09/2011
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name POONEH POONEH
Position PRESIDENT/DENTIST
Phone (817) 237-1600
Fax (817) 237-2604
Practice Location
3980 BOAT CLUB RD STE 114
LAKE WORTH TX, 76135-3206, US
Phone (817) 237-1600
Fax (817) 237-2604
Business Location
3980 BOAT CLUB RD STE 114
LAKE WORTH TX, 76135-3206, US
Phone (817) 237-1600
Fax (817) 237-2604
Toxanomy
Taxonomy Code 1223G0001X
License State Texas
License Number 20085
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According to our database, Bluebonnet Dental Care NPI is 1033496716, taxonomy code is 1223G0001X and license number is 20085, license state is located at Texas. Bluebonnet Dental Care physically located at 3980 Boat Club Rd Ste 114, Lake Worth TX, 76135-3206. NPI Number 1033115704 has the healthcare provider type.

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1033496716 NPI number is provided on an as is basis without warranty of any kind. 1033496716 is maintained by the National Plan & Provider Enumeration System. The contents of Bluebonnet Dental Care are for informational purposes only.