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Organization
PARKSIDE AUSTIN DENTAL PLLC
Active
Organization
PARKSIDE AUSTIN DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAITH GASKINS (DIRECTOR OF CREDENTIALING)
(972) 869-3789
Entity
Organization
Contact information
Practice address
10001 S INTERSTATE 35 STE 350, AUSTIN, TX 78747-1705
(512) 280-1216
Mailing address
2403 LACY LN, CARROLLTON, TX 75006-6514
(972) 869-3789
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/24/2019
Last updated
01/24/2019
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