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Organization
MY LOCAL TEXAS DENTAL PRACTICE, PLLC
Active
Organization
MY LOCAL TEXAS DENTAL PRACTICE, PLLC
Active
Parent organization
MY LOCAL TEXAS DENTAL PRACTICE, PLLC
Other names
Premier Dental Center Lockhart
Organization subpart
Yes
Provider details
NPI number
Legal business name
MY LOCAL TEXAS DENTAL PRACTICE, PLLC
Authorized official
MICHELLE JOHNSON (CREDENTIALING SPECIALIST)
(509) 315-8338
Entity
Organization
Contact information
Practice address
701 STATE PARK RD, LOCKHART, TX 78644-4934
(512) 398-4934
Mailing address
701 STATE PARK RD, LOCKHART, TX 78644-4934
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/09/2021
Last updated
06/09/2021
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