| |
3607 Manor Rd # 103 Austin TX 78723 | |
(512) 270-1071 | |
Not Available |
Full Name | |
---|---|
Speciality | Dentist - Pediatric Dentistry |
Location | 3607 Manor Rd # 103, Austin, Texas |
Authorized Official Name and Position | Chang Ryu (OWNER) |
Authorized Official Contact | 5124946767 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
3607 Manor Rd # 103 Austin TX 78723-5812 Ph: () - | 3607 Manor Rd # 103 Austin TX 78723 Ph: (512) 270-1071 |
NPI Number | 1740799048 |
---|---|
Provider Enumeration Date | 09/29/2017 |
Last Update Date | 08/13/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1740799048 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | 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 | |