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6500 N Mo Pac Expy Bldg Ii Suite #2204 Austin TX 78731-3282 | |
| (512) 458-3111 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6500 N Mo Pac Expy Bldg Ii, Austin, Texas |
| Authorized Official Name and Position | Logan Miller (OWNER/MANAGER) |
| Authorized Official Contact | 2087775264 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1401 Colorado Bend Dr Cedar Park TX 78613-6981 Ph: (208) 777-5264 | 6500 N Mo Pac Expy Bldg Ii Suite #2204 Austin TX 78731-3282 Ph: (512) 458-3111 |
| NPI Number | 1124479175 |
|---|---|
| Provider Enumeration Date | 06/30/2016 |
| Last Update Date | 06/30/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124479175 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 31875 (Texas) | 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 | |