Organization
AUSTIN DENTAL WESTLAKE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESTINA OLIVARES (BUSINESS OPERATIONS MANAGER)
(512) 731-3895
Entity
Organization
Contact information
Practice address
8825 FM 2244 RD STE E, AUSTIN, TX 78746-4720
(512) 263-8332
Mailing address
8825 BEE CAVES RD STE E, AUSTIN, TX 78746-4720
(512) 263-8332
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427273382
INDIVIDUAL
TX
01
—
1528282407
INDIVIDUAL
TX
01
—
1780318337
INDIVIDUAL
TX
Enumeration date
05/11/2022
Last updated
06/29/2023
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