Individual
OMAN KONIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1612 E. WILLIAM CANNON DR, APT 1805, AUSTIN, TX 78744
(512) 640-7999
Mailing address
44 EAST AVE UNIT 1805, AUSTIN, TX 78701-1185
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
40037
TX
Other
Enumeration date
09/11/2023
Last updated
09/25/2023
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