Organization
BUTTERFLY PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. POONEH JAHADI PHD (OFFICE MANAGER)
(512) 206-2929
Entity
Organization
Contact information
Practice address
4201 MARATHON BLVD, SUITE 302, AUSTIN, TX 78756-3436
(512) 206-2929
Mailing address
4201 MARATHON BLVD, SUITE 302, AUSTIN, TX 78756-3436
(512) 206-2929
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
174364301
—
TX
Enumeration date
08/05/2008
Last updated
08/05/2008
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