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Organization
RANDALL KIES DDS
Active
Organization
RANDALL KIES DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL KIES DDS (OWNER)
(512) 445-5866
Entity
Organization
Contact information
Practice address
4029 S CAPITAL OF TEXAS HWY, STE 109, AUSTIN, TX 78704-7927
(512) 445-5866
Mailing address
4029 S CAPITAL OF TEXAS HWY, STE 109, AUSTIN, TX 78704-7927
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11098
TX
1223G0001X
General Practice Dentistry
21186
TX
1223P0700X
Prosthodontics
7037
TX
Other
Enumeration date
04/28/2011
Last updated
04/28/2011
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