# LAUREL DENTAL TX PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174139190
- **Authorized official:** DR. ALIISHA CHOUCAIR DMD (MANAGING MEMBER)
- **Authorized official phone:** (512) 900-1720

## Contact information

- **Practice address:** 10824 E CRYSTAL FALLS PKWY \# 303, LEANDER, TX 78641-4300
- **Practice address phone:** (801) 598-9676
- **Mailing address:** 10824 E CRYSTAL FALLS PKWY \# 303, LEANDER, TX 78641-4300
- **Mailing address phone:** (512) 900-1720

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/16/2020
- **Last updated:** 11/03/2020