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4410 E Riverside Dr Suite 150 Austin TX 78741-4799 | |
(512) 385-4700 | |
(512) 389-9797 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 4410 E Riverside Dr, Austin, Texas |
Authorized Official Name and Position | Jackson Booth (OWNER) |
Authorized Official Contact | 5127399440 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 2639 Kyle TX 78640-1817 Ph: (512) 820-6927 | 4410 E Riverside Dr Suite 150 Austin TX 78741-4799 Ph: (512) 385-4700 |
NPI Number | 1316213762 |
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Provider Enumeration Date | 03/30/2012 |
Last Update Date | 03/30/2012 |
Identifier | Type | State | Issuer |
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1316213762 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | 23496 (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 | |