Organization
AUSTECH DENTAL, PLLC
Active
Other names
Austin Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DESTINA OLIVARES (BUSINESS OPERATIONS MANAGER)
(512) 835-1924
Entity
Organization
Contact information
Practice address
2206 W PARMER LN, AUSTIN, TX 78727-4330
(512) 835-1924
(512) 835-2585
Mailing address
2206 W PARMER LN, AUSTIN, TX 78727-4330
(512) 835-1924
(512) 835-2585
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
13505
TX
1223G0001X
General Practice Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427273382
INDIVIDUAL
TX
01
—
1447748090
INDIVIDUAL
TX
01
—
1528282407
INDIVIDUAL
TX
01
—
1619600475
INDIVIDUAL
TX
Enumeration date
01/29/2007
Last updated
06/29/2023
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