| Austin Dsg, Pllc | |
|
5000 Davis Ln Suite #101 Austin TX 78749-3683 | |
| (512) 441-6200 | |
| Not Available |
| Full Name | Austin Dsg, Pllc |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 5000 Davis Ln, Austin, Texas |
| Authorized Official Name and Position | Pejman Khosravian (CEO) |
| Authorized Official Contact | 5127226338 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Austin Dsg, Pllc 1920 Corporate Dr Unit #107a San Marcos TX 78666-6283 Ph: (512) 722-6338 | Austin Dsg, Pllc 5000 Davis Ln Suite #101 Austin TX 78749-3683 Ph: (512) 441-6200 |
| NPI Number | 1518313337 |
|---|---|
| Provider Enumeration Date | 05/11/2016 |
| Last Update Date | 05/11/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518313337 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 25904 (Texas) | Primary |
| 1223P0221X | Dentist - Pediatric Dentistry | 25904 (Texas) | Secondary |
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