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Organization
LEANDER PERIODONTICA PA
Active
Organization
LEANDER PERIODONTICA PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN R. CALLIA D.D.S., M.S. (DOCTOR)
(512) 337-2578
Entity
Organization
Contact information
Practice address
2301 BAGDAD RD STE 201, CEDAR PARK, TX 78613-6501
(512) 337-2578
Mailing address
2301 BAGDAD RD STE 201, CEDAR PARK, TX 78613-6501
(512) 337-2578
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
20343
TX
Other
Enumeration date
10/21/2016
Last updated
10/21/2016
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