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6211 W William Cannon Dr Austin TX 78749-1923 | |
| (737) 260-3888 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6211 W William Cannon Dr, 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 |
|---|---|
6211 W William Cannon Dr Austin TX 78749-1923 Ph: (737) 260-3888 | 6211 W William Cannon Dr Austin TX 78749-1923 Ph: (737) 260-3888 |
| NPI Number | 1720706682 |
|---|---|
| Provider Enumeration Date | 08/17/2022 |
| Last Update Date | 12/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720706682 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (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 | |