| Vida Dental Central | |
|
711 W 38th St Ste B10 Austin TX 78705-1135 | |
| (512) 454-5825 | |
| Not Available |
| Full Name | Vida Dental Central |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 711 W 38th St Ste B10, Austin, Texas |
| Authorized Official Name and Position | Marcin Bednarski (OWNER) |
| Authorized Official Contact | 5124545825 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vida Dental Central 711 W 38th St Ste B10 Austin TX 78705-1135 Ph: (512) 454-5825 | Vida Dental Central 711 W 38th St Ste B10 Austin TX 78705-1135 Ph: (512) 454-5825 |
| NPI Number | 1063934263 |
|---|---|
| Provider Enumeration Date | 07/10/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063934263 | NPI | - | NPPES |
| 363097201 | Medicaid | TX | |
| 32051 | Other | TX | TEXAS DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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