Provider Demographics
NPI:1306084710
Name:BAUER FAMILY DENTISTRY PLLC
Entity type:Organization
Organization Name:BAUER FAMILY DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:BAUER
Authorized Official - Suffix:II
Authorized Official - Credentials:DDS
Authorized Official - Phone:830-775-2421
Mailing Address - Street 1:551 W CANTU RD
Mailing Address - Street 2:
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78840-3013
Mailing Address - Country:US
Mailing Address - Phone:830-775-2421
Mailing Address - Fax:830-774-4231
Practice Address - Street 1:551 W CANTU RD
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-3013
Practice Address - Country:US
Practice Address - Phone:830-775-2421
Practice Address - Fax:830-774-4231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty