# MICHAEL ALLEN CIAVERELLI, DDS, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Brodie Oaks Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619220811
- **Authorized official:** DR. MICHAEL CIAVERELLI DDS (PRESIDENT)
- **Authorized official phone:** (512) 445-5866

## Contact information

- **Practice address:** 4029 S CAPITAL OF TEXAS HWY, SUITE 109, AUSTIN, TX 78704-7927
- **Practice address phone:** (512) 445-5866
- **Practice address fax:** (512) 445-4262
- **Mailing address:** 4029 S CAPITAL OF TEXAS HWY, SUITE 109, AUSTIN, TX 78704-7927
- **Mailing address phone:** (512) 445-5866
- **Mailing address fax:** (512) 445-4262

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/25/2012
- **Last updated:** 10/25/2012