| Austin Dental Center, Pc | |
|
2304 Hancock Dr Ste 1 Austin TX 78756-2537 | |
| (512) 454-0414 | |
| (512) 454-0426 |
| Full Name | Austin Dental Center, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2304 Hancock Dr Ste 1, Austin, Texas |
| Authorized Official Name and Position | John N Glennon (PRESIDENT) |
| Authorized Official Contact | 5122635034 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Austin Dental Center, Pc 2304 Hancock Dr Ste 1 Austin TX 78756-2537 Ph: (512) 454-0414 | Austin Dental Center, Pc 2304 Hancock Dr Ste 1 Austin TX 78756-2537 Ph: (512) 454-0414 |
| NPI Number | 1629189774 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629189774 | NPI | - | NPPES |
| 825457 | Other | UNITED CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 15791 (Texas) | Primary |
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