Countywide Dental PA

NPI #1902069263 in Cleburne, Texas

Provider Information

NPI Number: 1902069263
Entity Type: Organization
Organization Name: Countywide Dental PA
Primary Specialty: Dentist
Enumeration Date: Jul 8, 2008
Last Updated: Jul 8, 2008

Practice Location

Address: 622 N MAIN ST
City: Cleburne
State: Texas
ZIP Code: 76033-3842
Phone: (817) 517-7557

Authorized Official

Name: DR. RICHARD L BULLARD, DDS
Title: OWNER/DENTIST
Phone: (817) 517-7557

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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