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Organization
RIVER ROCK DENTAL, P.C.
Active
Organization
RIVER ROCK DENTAL, P.C.
Active
Other names
River Rock Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACKSON BOOTH DDS (OWNER)
(512) 739-9440
Entity
Organization
Contact information
Practice address
4410 E RIVERSIDE DR, SUITE 150, AUSTIN, TX 78741-4799
(512) 385-4700
(512) 389-9797
Mailing address
PO BOX 2639, KYLE, TX 78640-1817
(512) 820-6927
(512) 262-7074
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
23496
TX
Other
Enumeration date
03/30/2012
Last updated
03/30/2012
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