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101 Colorado St 1605 Austin TX 78701-4103 | |
| (979) 778-6010 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 101 Colorado St, Austin, Texas |
| Authorized Official Name and Position | Nieku Manshadi (PRESIDENT) |
| Authorized Official Contact | 9797786010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
101 Colorado St 1605 Austin TX 78701-4103 Ph: (979) 778-6010 | 101 Colorado St 1605 Austin TX 78701-4103 Ph: (979) 778-6010 |
| NPI Number | 1447520713 |
|---|---|
| Provider Enumeration Date | 01/04/2012 |
| Last Update Date | 03/14/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447520713 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | 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 | |