Organization
IMYO: OROFACIAL MYOLOGY OF CENTRAL TEXAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSICA N. CAIN BSRDH.COM (CERTIFIED OROFACIAL MYOLOGIST)
(512) 826-2527
Entity
Organization
Contact information
Practice address
4749 WILLIAMS DR STE 334450, GEORGETOWN, TX 78633-3710
(512) 826-2527
Mailing address
4749 WILLIAMS DR STE 334450, GEORGETOWN, TX 78633-3710
(512) 826-2527
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
14525
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780199976
COMMERCIAL INSURANCE CARRIERS
TX
Enumeration date
04/25/2018
Last updated
12/30/2020
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