Custom Dental of Bonham Pllc

NPI #1437795093 in Bonham, Texas

Provider Information

NPI Number: 1437795093
Entity Type: Organization
Organization Name: Custom Dental of Bonham Pllc
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Nov 19, 2019
Last Updated: Sep 8, 2021

Practice Location

Address: 2016 STATE HIGHWAY 121 N
City: Bonham
State: Texas
ZIP Code: 75418
Phone: (903) 227-6576

Authorized Official

Name: BRYCE GATES, DDS
Title: DENTIST
Phone: (405) 227-6100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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