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Organization
RIVER ROCK PEDIATRIC DENTISTRY, PC
Active
Organization
RIVER ROCK PEDIATRIC DENTISTRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACKSON BOOTH DDS (OWNER)
(512) 739-9440
Entity
Organization
Contact information
Practice address
5900 W SLAUGHTER LN, SUITE 470, AUSTIN, TX 78749-6511
(512) 462-4775
(512) 462-4782
Mailing address
5717 S IH 35, BLDG B, SUITE 101, AUSTIN, TX 78744-2711
(512) 462-4775
(512) 462-4782
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
23496
TX
Other
Enumeration date
08/19/2015
Last updated
08/19/2015
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