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Organization
TEXAS PERIODONTISTS PC
Active
Organization
TEXAS PERIODONTISTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA DIXON (MANAGER)
(512) 222-5721
Entity
Organization
Contact information
Practice address
12319 N MOPAC EXPY STE 160, AUSTIN, TX 78758-2648
(512) 222-5721
(512) 309-5273
Mailing address
12319 N MOPAC EXPY STE 160, AUSTIN, TX 78758-2648
(512) 222-5721
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
07/19/2023
Last updated
08/01/2023
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