|
| |
|
1801 E 51st St. Suite 390 Austin TX 78723 | |
| (512) 385-4700 | |
| (512) 389-9797 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1801 E 51st St., 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 |
|---|---|
4410 E Riverside Dr Suite 150 Austin TX 78741-4799 Ph: (512) 385-4700 | 1801 E 51st St. Suite 390 Austin TX 78723 Ph: (512) 385-4700 |
| NPI Number | 1740529965 |
|---|---|
| Provider Enumeration Date | 02/07/2013 |
| Last Update Date | 02/07/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740529965 | 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 | |