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5717 South Ih 35 Bldg B Suite #101 Austin TX 78744 | |
| (512) 462-4775 | |
| (512) 462-4782 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5717 South Ih 35, 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) 206-4484 | 5717 South Ih 35 Bldg B Suite #101 Austin TX 78744 Ph: (512) 462-4775 |
| NPI Number | 1801218854 |
|---|---|
| Provider Enumeration Date | 01/10/2014 |
| Last Update Date | 01/10/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801218854 | 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 | |