| River Rock Dental | |
|
1192 Airport Blvd Suite B Austin TX 78702-3176 | |
| (512) 820-6927 | |
| (512) 262-7074 |
| Full Name | River Rock Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1192 Airport Blvd, 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 |
|---|---|
| River Rock Dental Po Box 2638 Kyle TX 78640-1817 Ph: (512) 385-4700 | River Rock Dental 1192 Airport Blvd Suite B Austin TX 78702-3176 Ph: (512) 820-6927 |
| NPI Number | 1356616825 |
|---|---|
| Provider Enumeration Date | 03/17/2012 |
| Last Update Date | 03/17/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356616825 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 23496 (Texas) | Primary |
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