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10703 E Crystal Falls Pkwy Leander TX 78641-2259 | |
| (512) 260-9333 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 10703 E Crystal Falls Pkwy, Leander, Texas |
| Authorized Official Name and Position | Jonathan Tucker (OWNER) |
| Authorized Official Contact | 5122609333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
10703 E Crystal Falls Pkwy Leander TX 78641-2259 Ph: (512) 260-9333 | 10703 E Crystal Falls Pkwy Leander TX 78641-2259 Ph: (512) 260-9333 |
| NPI Number | 1497955710 |
|---|---|
| Provider Enumeration Date | 07/24/2007 |
| Last Update Date | 06/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497955710 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 22102 (Texas) | Primary |
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