# AUSTIN PRIMARY DENTAL INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497991210
- **Authorized official:** DR. JAYASHREE KYATAM D.M.D (PRESIDENT)
- **Authorized official phone:** (512) 440-1333

## Contact information

- **Practice address:** 6700 W GATE BLVD, STE 103, AUSTIN, TX 78745-4867
- **Practice address phone:** (512) 440-1333
- **Practice address fax:** (512) 440-0484
- **Mailing address:** 6700 W GATE BLVD, STE 103, AUSTIN, TX 78745-4867
- **Mailing address phone:** (512) 440-1333
- **Mailing address fax:** (512) 440-0484

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 22247 | TX | Yes |

## Other

- **Enumeration date:** 12/29/2008
- **Last updated:** 12/29/2008