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Organization
TEXDENTGROUP
Active
Organization
TEXDENTGROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT HEWITT (PRESIDENT)
(512) 762-0378
Entity
Organization
Contact information
Practice address
1802 ANDERSON LANE, AUSTIN, TX 78757
(512) 459-4347
(512) 459-4348
Mailing address
2609 PADINA DR, AUSTIN, TX 78733-1666
(512) 569-5557
(512) 263-1490
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
17310
TX
Other
Enumeration date
09/01/2011
Last updated
09/01/2011
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