Round Rock Dental Center | |
905 Ih 35 N Suite 109 Round Rock TX 78664-4254 | |
(512) 733-2100 | |
(512) 733-2101 |
Full Name | Round Rock Dental Center |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 905 Ih 35 N, Round Rock, Texas |
Authorized Official Name and Position | Peter C Perialas (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 5128681124 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Round Rock Dental Center 1500 West University Avenue Suite 103 Georgetown TX 78628-7109 Ph: (512) 868-1124 | Round Rock Dental Center 905 Ih 35 N Suite 109 Round Rock TX 78664-4254 Ph: (512) 733-2100 |
NPI Number | 1003051673 |
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Provider Enumeration Date | 12/10/2008 |
Last Update Date | 12/10/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003051673 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Texas) | Primary |
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