Countywide Dental PA

Primary specialty

DentistTaxonomy code 122300000X

License

21787 Issued in TX

Legal business name

COUNTYWIDE DENTAL PA

Practice address

622 N Main St
Cleburne, TX 76033-3842

Phone

(817) 517-7557

Fax

(817) 641-2779

NPI assigned

Jul 8, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Richard L Bullard, DDS

Title

Owner/Dentist

Phone

(817) 517-7557

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215475200000",
    "number": "1902069263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 N MAIN ST",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760333842",
            "telephone_number": "817-517-7557",
            "fax_number": "817-641-2779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 N MAIN ST",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760333842",
            "telephone_number": "817-517-7557",
            "fax_number": "817-641-2779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTYWIDE DENTAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-08",
        "last_updated": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "BULLARD",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "817-517-7557",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "21787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Michelle Colwick, D.D.S., M.S.
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• Nathan Copeland, PT, DPT
• Priscilla E Corson, LCSW
• Coryell County Memorial Hospital Authority
• Audrey R. Cowan, CRNA
• Jennifer Cox, LPC
• Pamela Sue Coym, M.ED. LPC
• Rachel Crawley, LPC
• Melaina Crocker

• Dentist in Cleburne, TX
• Providers in Cleburne, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.