Provider Demographics
NPI:1134498520
Name:PAXTON, BARTHOLOMEW MACKAY (DDS)
Entity Type:Individual
Prefix:
First Name:BARTHOLOMEW
Middle Name:MACKAY
Last Name:PAXTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 RUFE SNOW DR STE 111
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-2111
Mailing Address - Country:US
Mailing Address - Phone:817-337-7941
Mailing Address - Fax:817-337-7942
Practice Address - Street 1:121 RUFE SNOW DR STE 111
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-2111
Practice Address - Country:US
Practice Address - Phone:817-337-7941
Practice Address - Fax:817-337-7942
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-14
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31518122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist