# BASTROP MODERN DENTISTRY,PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bastrop Modern Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093252611
- **Authorized official:** DR. JOHN S BARNES DDS (OWNER DENTIST)
- **Authorized official phone:** (512) 240-6496

## Contact information

- **Practice address:** 1670 HWY 71 E, SUITE A, BASTROP, TX 78602
- **Practice address phone:** (512) 240-6496
- **Mailing address:** 17000 RED HILL AVE, IRVINE, CA 92614-5626
- **Mailing address phone:** (714) 845-8890

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 01/20/2017
- **Last updated:** 01/20/2017