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Organization
RDG ANGUS ROAD, PLLC
Active
Organization
RDG ANGUS ROAD, PLLC
Active
Other names
Rose Dental Group Angus
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA LIGHTFOOT (AUTHORIZED REPRESENTATIVE)
(214) 702-0708
Entity
Organization
Contact information
Practice address
11615 ANGUS RD STE 110, AUSTIN, TX 78759-4006
(512) 795-9643
Mailing address
11615 ANGUS RD STE 110, AUSTIN, TX 78759-4006
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
08/17/2022
Last updated
12/14/2022
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