# JASPER DENTAL EMPORIUM

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Rayburn General Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760939888
- **Authorized official:** DR. JOHN JOSHUA SEALE DDS (OWNER/DENTIST)
- **Authorized official phone:** (409) 698-8800

## Contact information

- **Practice address:** 3303 RECREATIONAL ROAD 255 WEST, BROOKELAND, TX 75931
- **Practice address phone:** (409) 698-8800
- **Practice address fax:** (409) 698-8801
- **Mailing address:** 3303 RECREATIONAL ROAD 255 WEST, BROOKELAND, TX 75931
- **Mailing address phone:** (409) 698-8800
- **Mailing address fax:** (409) 698-8801

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 15204 | TX | — |
| 122300000X | Dentist | 22917 | TX | Yes |

## Other

- **Enumeration date:** 09/07/2016
- **Last updated:** 09/07/2016