Blue Sky Family Dentistry | |
5915 La Crosse Ave Ste 105 Austin TX 78739-1747 | |
(919) 740-5096 | |
Not Available |
Full Name | Blue Sky Family Dentistry |
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Speciality | Clinic/center - Dental |
Location | 5915 La Crosse Ave Ste 105, Austin, Texas |
Authorized Official Name and Position | Ben Corpron (OWNER) |
Authorized Official Contact | 9197405096 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Blue Sky Family Dentistry 1905 Crooked Ln Austin TX 78741-3907 Ph: () - | Blue Sky Family Dentistry 5915 La Crosse Ave Ste 105 Austin TX 78739-1747 Ph: (919) 740-5096 |
NPI Number | 1679071633 |
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Provider Enumeration Date | 01/24/2018 |
Last Update Date | 01/24/2018 |
Identifier | Type | State | Issuer |
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1679071633 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | 33478 (Texas) | Primary |
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