# BLUE SKY FAMILY DENTISTRY

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

## Provider details

- **NPI number:** 1679071633
- **Authorized official:** BEN CORPRON DDS (OWNER)
- **Authorized official phone:** (919) 740-5096

## Contact information

- **Practice address:** 5915 LA CROSSE AVE STE 105, AUSTIN, TX 78739-1747
- **Practice address phone:** (919) 740-5096
- **Mailing address:** 1905 CROOKED LN, AUSTIN, TX 78741-3907

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 33478 | TX | Yes |

## Other

- **Enumeration date:** 01/24/2018
- **Last updated:** 01/24/2018