| Evan Pedersen Dmd, Pllc | |
|
18101 W State Highway 71 Ste 100 Austin TX 78738-0017 | |
| (512) 777-0866 | |
| Not Available |
| Full Name | Evan Pedersen Dmd, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 18101 W State Highway 71 Ste 100, Austin, Texas |
| Authorized Official Name and Position | Evan Pedersen (OWNER) |
| Authorized Official Contact | 8159758758 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evan Pedersen Dmd, Pllc 6726 Lancret Hill Dr # B Austin TX 78745-4717 Ph: () - | Evan Pedersen Dmd, Pllc 18101 W State Highway 71 Ste 100 Austin TX 78738-0017 Ph: (512) 777-0866 |
| NPI Number | 1962110817 |
|---|---|
| Provider Enumeration Date | 11/09/2022 |
| Last Update Date | 11/09/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962110817 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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