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Organization
RIVER ROCK - AIRPORT, P.C.
Active
Organization
RIVER ROCK - AIRPORT, 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
1192 AIRPORT BLVD, SUITE B, AUSTIN, TX 78702-3176
(512) 820-6927
(512) 262-7074
Mailing address
PO BOX 2638, KYLE, TX 78640-1817
(512) 385-4700
(512) 389-9797
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
23496
TX
Other
Enumeration date
03/17/2012
Last updated
03/17/2012
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