|
| |
|
711 W. 38th St. Suite E-4 Austin TX 78705 | |
| (512) 479-6633 | |
| (512) 479-6617 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 711 W. 38th St., Austin, Texas |
| Authorized Official Name and Position | Jeannie Nelson (DIRECTOR OF DENTAL SERVICES) |
| Authorized Official Contact | 5129003471 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 4874 Austin TX 78765 Ph: (512) 458-2437 | 711 W. 38th St. Suite E-4 Austin TX 78705 Ph: (512) 479-6633 |
| NPI Number | 1760500078 |
|---|---|
| Provider Enumeration Date | 03/26/2007 |
| Last Update Date | 05/19/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760500078 | 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 | |