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Organization
PARKSIDE ENDODONTICS, PC
Active
Organization
PARKSIDE ENDODONTICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACKSON BOOTH DDS (OWNER)
(512) 820-6927
Entity
Organization
Contact information
Practice address
10001 S IH 35, SUITE 350, AUSTIN, TX 78747-1701
(512) 280-1216
(512) 280-1217
Mailing address
10001 S IH 35, SUITE 350, AUSTIN, TX 78747-1701
(512) 280-1216
(512) 280-1217
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
23496
TX
Other
Enumeration date
06/12/2015
Last updated
06/12/2015
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