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Organization
SOUTHPARK AUSTIN DENTAL PLLC
Active
Organization
SOUTHPARK AUSTIN DENTAL PLLC
Active
Other names
River Rock Dental
Organization subpart
No
Provider details
NPI number
Authorized official
FAITH GASKINS (DIRECTOR OF CREDENTIALING)
(972) 869-3789
Entity
Organization
Contact information
Practice address
9500 S INTERSTATE 35 STE E400, AUSTIN, TX 78748-1990
(512) 282-7200
Mailing address
PO BOX 734753, DALLAS, TX 75373-4753
(972) 869-3789
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/24/2019
Last updated
04/26/2023
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