# BANDERA MODERN DENTISTRY, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bandera Modern Dentistry, PC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184981433
- **Authorized official:** DR. JOHN S BARNES (DDS- OWNER)
- **Authorized official phone:** (210) 681-1121

## Contact information

- **Practice address:** 9234 NORTH LOOP 1604 W, SUITE 121, SAN ANTONIO, TX 78249
- **Practice address phone:** (210) 681-1121
- **Practice address fax:** (210) 681-1321
- **Mailing address:** 17000 RED HILL AVE, IRVINE, CA 92614-5626
- **Mailing address phone:** (714) 845-8890
- **Mailing address fax:** (949) 474-1495

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 12406 | TX | Yes |

## Other

- **Enumeration date:** 04/11/2012
- **Last updated:** 01/02/2014