Individual
DR. LUKE RYAN TIBBITTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
901 W 38TH ST STE 410, AUSTIN, TX 78705-1162
(512) 992-1378
Mailing address
901 W 38TH ST STE 410, AUSTIN, TX 78705-1162
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
9954
KY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
38316
TX
Other
Enumeration date
03/23/2017
Last updated
07/07/2023
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