|
| |
|
211 San Antonio St Austin TX 78701-4063 | |
| (512) 330-9403 | |
| (512) 373-3408 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 211 San Antonio St, Austin, Texas |
| Authorized Official Name and Position | Shane Eden Matt (OWNER) |
| Authorized Official Contact | 5123309403 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
211 San Antonio St Austin TX 78701-4063 Ph: (512) 330-9403 | 211 San Antonio St Austin TX 78701-4063 Ph: (512) 330-9403 |
| NPI Number | 1033511084 |
|---|---|
| Provider Enumeration Date | 09/22/2014 |
| Last Update Date | 09/22/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033511084 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (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 | |