Full Name | |
---|---|
Speciality | Dentist - General Practice |
Location | 3115 S. Lamar, 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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9500 S Ih 35 Suite E-400 Austin TX 78748-1752 Ph: (512) 820-6927 | 3115 S. Lamar Austin TX 78704 Ph: (512) 820-6927 |
NPI Number | 1841699907 |
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Provider Enumeration Date | 08/14/2014 |
Last Update Date | 08/14/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1841699907 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
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 | |