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Organization
SHADY HOLLOW DENTAL PLLC
Active
Organization
SHADY HOLLOW DENTAL PLLC
Active
Other names
Oak Park Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEETIKA RASTOGI (OWNER)
(832) 369-6941
Entity
Organization
Contact information
Practice address
9901 BRODIE LN STE 130, AUSTIN, TX 78748-5889
(281) 328-4900
(877) 291-5828
Mailing address
3838 N SAM HOUSTON PKWY E STE 430, HOUSTON, TX 77032-3418
(832) 369-6775
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295967164
—
TX
Enumeration date
01/06/2021
Last updated
09/26/2022
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