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Organization

AUSTIN BLVD. FAMILY DENTISTRY, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALAN MARTIN D.D.S. (PRESIDENT)
(972) 617-3322
Entity
Organization

Contact information

Practice address
101 AUSTIN BLVD., STE 100, RED OAK, TX 75154
(770) 916-5031
Mailing address
1090 NORTHCHASE PKWY STE. 150, MARIETTA, GA 30067

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
1223E0200X
Endodontics
1223G0001X
General Practice Dentistry
Primary
1223P0221X
Pediatric Dentistry
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry

Other

Enumeration date
04/07/2017
Last updated
04/13/2017
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