| Pediatric Dental Professionals | |
|
9015 Mountain Ridge Dr Ste 320 Austin TX 78759-8488 | |
| (512) 846-7507 | |
| Not Available |
| Full Name | Pediatric Dental Professionals |
|---|---|
| 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 |
|---|---|
| Pediatric Dental Professionals 9015 Mountain Ridge Dr Ste 320 Austin TX 78759-8488 Ph: (214) 702-0729 | Pediatric Dental Professionals 9015 Mountain Ridge Dr Ste 320 Austin TX 78759-8488 Ph: (512) 846-7507 |
| NPI Number | 1356956882 |
|---|---|
| Provider Enumeration Date | 09/11/2020 |
| Last Update Date | 11/09/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356956882 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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