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Organization

AUSTIN PEDIATRIC DENTISTRY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOSHUA LUCAS (CFO)
(512) 887-2319
Entity
Organization

Contact information

Practice address
6618 SITIO DEL RIO BLVD, STE B102, AUSTIN, TX 78730-1143
(512) 900-5437
(512) 857-1042
Mailing address
6618 SITIO DEL RIO BLVD, STE B102, AUSTIN, TX 78730-1143
(512) 900-5437
(512) 857-1042

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
29246
TX

Other

Enumeration date
03/12/2014
Last updated
03/12/2014
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