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Organization
GRAND LAKES DENTAL GROUP AND ORTHODONTICS, PC
Active
Organization
GRAND LAKES DENTAL GROUP AND ORTHODONTICS, PC
Active
Other names
Grand Lakes Dental Group and Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN S BARNES D.D.S. (OWNER)
(281) 574-5005
Entity
Organization
Contact information
Practice address
6501 SOUTH FRY ROAD, SUITE 800, KATY, TX 77494
(281) 574-5005
(281) 574-5085
Mailing address
17000 RED HILL AVE, IRVINE, CA 92614-5626
(714) 845-8890
(949) 474-1495
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/07/2013
Last updated
12/31/2013
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