Pecan Street Dental | |
708 Pecan St Bastrop TX 78602-3816 | |
(512) 321-2188 | |
Not Available |
Full Name | Pecan Street Dental |
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Speciality | Dentist |
Location | 708 Pecan St, Bastrop, Texas |
Authorized Official Name and Position | Kevin Deutsch (OWNER) |
Authorized Official Contact | 5123212188 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Pecan Street Dental 708 Pecan St Bastrop TX 78602-3816 Ph: () - | Pecan Street Dental 708 Pecan St Bastrop TX 78602-3816 Ph: (512) 321-2188 |
NPI Number | 1558813030 |
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Provider Enumeration Date | 10/31/2016 |
Last Update Date | 10/31/2016 |
Identifier | Type | State | Issuer |
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1558813030 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | 25628 (Texas) | Primary |
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