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Organization
GRAND TRAILS DENTAL
Active
Organization
GRAND TRAILS DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUSTIN BAKER (DENTIST/OWNER)
(832) 616-8822
Entity
Organization
Contact information
Practice address
28533 SPRING TRAILS RDG, SUITE 250, SPRING, TX 77386-4355
(832) 616-8822
Mailing address
28533 SPRING TRAILS RDG, SUITE 250, SPRING, TX 77386-4355
(832) 616-8822
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
29936
TX
Other
Enumeration date
12/15/2016
Last updated
12/15/2016
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