Kenneth Wayne Bourgeois is a General Dentist in the TAMUNING area. Kenneth Wayne Bourgeois primary office location is at 226 CHALAN SAN ANTONIO STE C and new patients are welcome to contact this healthcare provider for an appointment. The NPI number is 1255561320 and the information was updated approximately 15 years ago.
We have not detected any Exclusions tied directly to this NPI.
Accepts Medicare Assignment: Unknown
Is sole proprietor: YES
Participates in PECOS: NO
License Number | State |
---|---|
14605 | TX |
D927 | GU |
Taxonomy | State | Primary? |
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General Dentist - Taxonomy Code 1223G0001X | GU | Y |
General Dentist - Taxonomy Code 1223G0001X | TX | N |