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6500 N Mo Pac Expy Ste 2103 Austin TX 78731-3282 | |
(512) 346-3427 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Dental |
Location | 6500 N Mo Pac Expy Ste 2103, Austin, Texas |
Authorized Official Name and Position | Lisa Lunderman (CLINICAL ADMINISTRATOR) |
Authorized Official Contact | 5123463427 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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6500 N Mo Pac Expy Ste 2103 Austin TX 78731-3282 Ph: () - | 6500 N Mo Pac Expy Ste 2103 Austin TX 78731-3282 Ph: (512) 346-3427 |
NPI Number | 1275095770 |
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Provider Enumeration Date | 04/03/2019 |
Last Update Date | 04/03/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275095770 | NPI | - | NPPES |
1407338874 | Other | TX | PPO |
1326489576 | Other | TX | PPO |
1841417466 | Other | TX | PPO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (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 | |