Organization
AUSTIN RIVERSIDE - DR, LLC
Active
Other names
Dental Republic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SON TRAN D.D.S. (PRESIDENT)
(972) 747-1400
Entity
Organization
Contact information
Practice address
2015 E RIVERSIDE DR, BLDG 2 STE C, AUSTIN, TX 78741-1324
(512) 264-7300
Mailing address
2515 MCKINNEY AVE, SUITE 940, DALLAS, TX 75201-1908
(972) 747-1400
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/27/2010
Last updated
04/22/2011
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