Provider Demographics
NPI:1942683859
Name:BELL SPRINGS DENTAL PA
Entity Type:Organization
Organization Name:BELL SPRINGS DENTAL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:A
Authorized Official - Last Name:LARUE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:512-858-2201
Mailing Address - Street 1:2201 W HIGHWAY 290
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-5464
Mailing Address - Country:US
Mailing Address - Phone:512-858-2201
Mailing Address - Fax:512-858-2205
Practice Address - Street 1:2201 W HIGHWAY 290
Practice Address - Street 2:
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-5464
Practice Address - Country:US
Practice Address - Phone:512-858-2201
Practice Address - Fax:512-858-2205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-09
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17122261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental