Provider Demographics
NPI:1619249208
Name:JARRELL FAMILY DENTISTRY, PLLC
Entity Type:Organization
Organization Name:JARRELL FAMILY DENTISTRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-868-5000
Mailing Address - Street 1:400 DEL WEBB BLVD
Mailing Address - Street 2:104
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78633-4354
Mailing Address - Country:US
Mailing Address - Phone:512-868-5000
Mailing Address - Fax:
Practice Address - Street 1:181 TOWN CENTER BLVD
Practice Address - Street 2:100
Practice Address - City:JARRELL
Practice Address - State:TX
Practice Address - Zip Code:76537
Practice Address - Country:US
Practice Address - Phone:512-868-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX231301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty