# FULSHEAR MODERN DENTISTRY,PC

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

## Provider details

- **NPI number:** 1306380183
- **Authorized official:** DR. JOHN S BARNES DDS (OWNER DENTIST)
- **Authorized official phone:** (281) 204-2156

## Contact information

- **Practice address:** 5102 FM 1463 SUITE 100, KATY, TX 77494
- **Practice address phone:** (281) 204-2156
- **Practice address fax:** (281) 547-7340
- **Mailing address:** 17000 RED HILL AVE, IRVINE, CA 92614-5626
- **Mailing address phone:** (714) 845-8701
- **Mailing address fax:** (949) 474-1495

## Taxonomy

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

## Other

- **Enumeration date:** 12/13/2016
- **Last updated:** 12/13/2016