Individual
DR. BRIAN J ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
893 N INTERSTATE 35 STE 200, ROUND ROCK, TX 78664-4311
(512) 310-9374
Mailing address
4101 MICHAEL NEILL DR, AUSTIN, TX 78730-1432
(210) 816-3824
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
34002
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34002
TEXAS DENTAL LICENSE
TX
Enumeration date
06/08/2018
Last updated
02/08/2019
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