Organization
LAKE TRAVIS PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REZA ARZEGAR D.D.S. (VICE PRESIDENT)
(512) 263-1000
Entity
Organization
Contact information
Practice address
1008 RR 620 S, SUITE # 201, LAKEWAY, TX 78734-5631
(512) 263-1000
Mailing address
1008 RR 620 S, SUITE # 201, LAKEWAY, TX 78734-5631
(512) 263-1000
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
22434
TX
Other
Enumeration date
04/06/2009
Last updated
04/06/2009
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