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3660 Stoneridge Rd Ste B101 Austin TX 78746-7759 | |
(512) 327-3631 | |
(512) 327-2234 |
Full Name | |
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Speciality | Dentist |
Location | 3660 Stoneridge Rd Ste B101, Austin, Texas |
Authorized Official Name and Position | Michael B Nussbaum (PRESIDENT) |
Authorized Official Contact | 5123273631 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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3660 Stoneridge Rd Ste B101 Austin TX 78746-7759 Ph: (512) 327-3631 | 3660 Stoneridge Rd Ste B101 Austin TX 78746-7759 Ph: (512) 327-3631 |
NPI Number | 1154494250 |
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Provider Enumeration Date | 11/16/2006 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 6103362280 |
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Medicare Enrollment ID | O20240725000356 |
Identifier | Type | State | Issuer |
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1154494250 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | 16292 (Texas) | 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 | |