Organization
PFLUGERVILLE PERIODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN CALLIA DDS, MS (SHAREHOLDER)
(512) 990-8550
Entity
Organization
Contact information
Practice address
2911 A W GRIMES BLVD, PFLUGERVILLE, TX 78660-5458
(512) 990-8550
Mailing address
2911 A W GRIMES BLVD, PFLUGERVILLE, TX 78660-5458
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
20343
TX
Other
Enumeration date
10/18/2017
Last updated
10/18/2017
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