John Mark Coulter, DDS Valid NPI
Individual provider · General Practice Dentistry · Lake Jackson, TX
- NPI
- 1457465619
- Type
- Individual (Type 1)
- Primary specialty
- General Practice Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223G0001X
- License number
- 13602 (TX)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2006-08-17
- Last updated
- 2007-07-08
Practice location
102 Flag Lake Dr Ste C
Lake Jackson, TX 77566-6215
(979) 297-1201