Organization
BLVD DENTISTRY AUSTIN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY PU (VP OF FINANCE)
(972) 869-3789
Entity
Organization
Contact information
Practice address
1920 E RIVERSIDE STE A-140, AUSTIN, TX 78741
(972) 869-3789
Mailing address
2403 LACY LN, CARROLLTON, TX 75006-6514
(972) 869-3789
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/14/2014
Last updated
10/14/2014
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