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Organization

MY LOCAL TEXAS DENTAL PRACTICE, PLLC

Active
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Organization

MY LOCAL TEXAS DENTAL PRACTICE, PLLC

Active
Parent organization
MY LOCAL TEXAS DENTAL PRACTICE, PLLC
Other names
Silver Screen
Organization subpart
Yes

Provider details

NPI number
Legal business name
MY LOCAL TEXAS DENTAL PRACTICE, PLLC
Authorized official
GREGORY KOSTELAC (DATA ANALYST)
(719) 372-5605
Entity
Organization

Contact information

Practice address
11851 JOLLYVILLE RD STE 201, AUSTIN, TX 78759-2350
(512) 345-8800
Mailing address
6110 BARNES RD, COLORADO SPRINGS, CO 80922-2600

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—

Other

Enumeration date
07/06/2022
Last updated
07/06/2022
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