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1614 E Riverside Dr Austin TX 78741-1006 | |
| (512) 707-7300 | |
| (512) 707-7302 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1614 E Riverside Dr, Austin, Texas |
| Authorized Official Name and Position | Mark Whitney Jumper (PRESIDENT) |
| Authorized Official Contact | 5128266559 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1614 E Riverside Dr Austin TX 78741-1006 Ph: (512) 707-7300 | 1614 E Riverside Dr Austin TX 78741-1006 Ph: (512) 707-7300 |
| NPI Number | 1457517773 |
|---|---|
| Provider Enumeration Date | 08/06/2008 |
| Last Update Date | 12/05/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457517773 | NPI | - | NPPES |
| 183823703 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 23174 (Texas) | Primary |
Jared Poplin D.m.d., Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6850 Austin Center Blvd Ste 220, Austin, TX 78731 Phone: 785-691-6171 | |
Ac Dentistry Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 13616 N Highway 183, Austin, TX 78750 Phone: 512-682-5437 | |