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2121 W Parmer Ln Ste 111 Austin TX 78727-4360 | |
| (512) 793-9325 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 2121 W Parmer Ln Ste 111, Austin, Texas |
| Authorized Official Name and Position | Dip Desai (OWNER) |
| Authorized Official Contact | 5177939325 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2121 W Parmer Ln Ste 111 Austin TX 78727-4360 Ph: (512) 793-9325 | 2121 W Parmer Ln Ste 111 Austin TX 78727-4360 Ph: (512) 793-9325 |
| NPI Number | 1477049690 |
|---|---|
| Provider Enumeration Date | 07/11/2018 |
| Last Update Date | 07/11/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477049690 | NPI | - | NPPES |
| 30390 | Other | TX | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 30390 (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 | |