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12201 Renfert Way #345 Austin TX 78758 | |
(512) 836-3074 | |
(512) 836-3252 |
Full Name | |
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Speciality | Dentist - Oral And Maxillofacial Surgery |
Location | 12201 Renfert Way, Austin, Texas |
Authorized Official Name and Position | Malcolm Ray Scott (PRESIDENT) |
Authorized Official Contact | 5123711222 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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7517 Cameron Road Suite 107 Longhorn Dental Associates Pc Austin TX 78752 Ph: () - | 12201 Renfert Way #345 Austin TX 78758 Ph: (512) 836-3074 |
NPI Number | 1477633113 |
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Provider Enumeration Date | 10/17/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1477633113 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (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 | |