East Austin Dental
Clinic/Center, Dental in Austin, TX. Organization (NPI-2).
NPI number1417485244
StatusActive
Last updated in NPPESJul 21, 2022
Details
- NPI
- 1417485244
- Entity type
- Organization (NPI-2)
- Legal business name
- East Austin Dental
- Organization subpart
- No
- Enumeration date
- May 24, 2017
- Last updated
- Jul 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | 28126 | TX | Yes |
Practice location
1000 E 5th St Ste 110Austin, TX 78702-3802
Phone 512-499-0067 · Fax 844-270-5426
Mailing address
1000 E 5th St Ste 110Austin, TX 78702-3802
Phone 512-499-0067 · Fax 844-270-5426
Authorized official
Adrian Bernal
Owner
5124990067
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