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4631 Airport Blvd Ste 120a Austin TX 78751-3453 | |
| (979) 777-3258 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4631 Airport Blvd, Austin, Texas |
| Authorized Official Name and Position | Ashley Smitherman (OWNER/PROVIDER) |
| Authorized Official Contact | 9797773258 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4631 Airport Blvd Ste 120a Austin TX 78751-3453 Ph: (979) 777-3258 | 4631 Airport Blvd Ste 120a Austin TX 78751-3453 Ph: (979) 777-3258 |
| NPI Number | 1255794087 |
|---|---|
| Provider Enumeration Date | 03/30/2016 |
| Last Update Date | 03/30/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255794087 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 28187 (Texas) | 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 | |