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9015 Mountain Ridge Dr Ste 320 Austin TX 78759-8488 | |
(512) 846-7507 | |
Not Available |
Full Name | |
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Speciality | Dentist - Pediatric Dentistry |
Location | 9015 Mountain Ridge Dr Ste 320, Austin, Texas |
Authorized Official Name and Position | Amanda Lightfoot (AUTHORIZED REPRESENTATIVE) |
Authorized Official Contact | 2147020708 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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9015 Mountain Ridge Dr Ste 320 Austin TX 78759-8488 Ph: (214) 702-0729 | 9015 Mountain Ridge Dr Ste 320 Austin TX 78759-8488 Ph: (512) 846-7507 |
NPI Number | 1356956882 |
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Provider Enumeration Date | 09/11/2020 |
Last Update Date | 11/09/2023 |
Identifier | Type | State | Issuer |
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1356956882 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223P0221X | Dentist - Pediatric Dentistry | (* (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 | |