| Great Grins Dental Pllc | |
|
5114 Balcones Woods Dr Ste 308 Austin TX 78759-5212 | |
| (512) 346-1900 | |
| Not Available |
| Full Name | Great Grins Dental Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5114 Balcones Woods Dr Ste 308, Austin, Texas |
| Authorized Official Name and Position | Brent Eugene Fossum (DENTIST) |
| Authorized Official Contact | 7139722044 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Grins Dental Pllc 5672 Rain Creek Pkwy Austin TX 78759-6201 Ph: (713) 972-2044 | Great Grins Dental Pllc 5114 Balcones Woods Dr Ste 308 Austin TX 78759-5212 Ph: (512) 346-1900 |
| NPI Number | 1144839390 |
|---|---|
| Provider Enumeration Date | 07/23/2020 |
| Last Update Date | 07/23/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144839390 | NPI | - | NPPES |
| 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 | |