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Organization
PRIME DENTAL OF CEDAR PARK PLLC
Active
Organization
PRIME DENTAL OF CEDAR PARK PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEEPAM TIWAN (MANAGER)
(512) 669-1291
Entity
Organization
Contact information
Practice address
821 W NEW HOPE DR STE 106, CEDAR PARK, TX 78613-2878
(512) 669-1291
Mailing address
821 W NEW HOPE DR STE 106, CEDAR PARK, TX 78613-2878
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
10/24/2024
Last updated
10/24/2024
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