| Dental Studio | |
|
1671 Main St Ste B Buda TX 78610-9732 | |
| (512) 295-5777 | |
| (512) 295-5030 |
| Full Name | Dental Studio |
|---|---|
| Speciality | Dentist |
| Location | 1671 Main St Ste B, Buda, Texas |
| Authorized Official Name and Position | Ross M Koeppen (OWNER) |
| Authorized Official Contact | 5122955777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Studio 1671 Main St Ste B Buda TX 78610-9732 Ph: (512) 295-5777 | Dental Studio 1671 Main St Ste B Buda TX 78610-9732 Ph: (512) 295-5777 |
| NPI Number | 1073834586 |
|---|---|
| Provider Enumeration Date | 06/18/2010 |
| Last Update Date | 04/21/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073834586 | NPI | - | NPPES |
| 213024701 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 0025123 (Texas) | Primary |
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