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Organization

DENTAL STUDIO

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROSS M KOEPPEN DDS (OWNER)
(512) 295-5777
Entity
Organization

Contact information

Practice address
1671 MAIN ST STE B, BUDA, TX 78610-9732
(512) 295-5777
(512) 295-5030
Mailing address
1671 MAIN ST STE B, BUDA, TX 78610-9732
(512) 295-5777
(512) 295-5030

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0025123
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
213024701
TX
Enumeration date
06/18/2010
Last updated
04/21/2015
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