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Organization
MYDENTAL AT MANOR PLLC
Active
Organization
MYDENTAL AT MANOR PLLC
Active
Other names
myDental at Manor
Organization subpart
No
Provider details
NPI number
Authorized official
JINAL PATEL DDS (OWNER)
(512) 815-3663
Entity
Organization
Contact information
Practice address
12836 HIGHWAY 290 E, SUITE 500, MANOR, TX 78653
(512) 815-3663
Mailing address
12836 US HIGHWAY 290 E STE 500, MANOR, TX 78653-5522
(512) 815-3663
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
03/15/2024
Last updated
03/22/2024
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