# JESTER DENTAL PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Jester Village Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306412416
- **Authorized official:** LAKSHMI BALARAMAN DDS (CEO/OWNER DOCTOR)
- **Authorized official phone:** (512) 966-3685

## Contact information

- **Practice address:** 6507 JESTER BLVD STE 303, AUSTIN, TX 78750-8357
- **Practice address phone:** (512) 418-9150
- **Mailing address:** 6507 JESTER BLVD STE 303, AUSTIN, TX 78750-8357
- **Mailing address phone:** (512) 418-9150

## Taxonomy

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

## Other

- **Enumeration date:** 05/29/2021
- **Last updated:** 06/03/2021