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2305 W William Cannon Dr Austin TX 78745-5319 | |
(512) 444-3494 | |
(512) 444-3864 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 2305 W William Cannon Dr, Austin, Texas |
Authorized Official Name and Position | Bhavani Sriramaneni (PRESIDENT) |
Authorized Official Contact | 5086629999 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2305 W William Cannon Dr Austin TX 78745-5319 Ph: (512) 444-3494 | 2305 W William Cannon Dr Austin TX 78745-5319 Ph: (512) 444-3494 |
NPI Number | 1386152304 |
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Provider Enumeration Date | 01/11/2018 |
Last Update Date | 01/11/2018 |
Identifier | Type | State | Issuer |
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1386152304 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Secondary |
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 | |