Organization
AUSTIN PRIMARY DENTAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAYASHREE KYATAM D.M.D (PRESIDENT)
(512) 440-1333
Entity
Organization
Contact information
Practice address
6700 W GATE BLVD, STE 103, AUSTIN, TX 78745-4867
(512) 440-1333
(512) 440-0484
Mailing address
6700 W GATE BLVD, STE 103, AUSTIN, TX 78745-4867
(512) 440-1333
(512) 440-0484
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22247
TX
Other
Enumeration date
12/29/2008
Last updated
12/29/2008
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