Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
JOLLYVILLE DENTAL PROFESSIONALS
Active
Organization
JOLLYVILLE DENTAL PROFESSIONALS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE DEE ROACH DDS (OWNER/DENTIST)
(512) 918-0005
Entity
Organization
Contact information
Practice address
11672 JOLLYVILLE RD, AUSTIN, TX 78759-3935
(512) 918-0005
(512) 918-0008
Mailing address
11672 JOLLYVILLE RD, AUSTIN, TX 78759-3935
(512) 918-0005
(512) 918-0008
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13219
TX
Other
Enumeration date
07/11/2007
Last updated
07/11/2007
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up