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Organization
JEANNIE ORTHODONTICS, PA
Active
Organization
JEANNIE ORTHODONTICS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN CANTU (CREDENTIALING SPECIALIST)
(512) 744-6000
Entity
Organization
Contact information
Practice address
730 W STASSNEY LN, SUITE 110, AUSTIN, TX 78745-2982
(512) 744-6000
(512) 892-7205
Mailing address
2621 RIDGEPOINT DR, SUITE 130, AUSTIN, TX 78754-5232
(512) 744-6000
(512) 892-7205
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/14/2010
Last updated
07/14/2010
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