Organization
AUSTIN DENTAL CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN N GLENNON DDS (PRESIDENT)
(512) 263-5034
Entity
Organization
Contact information
Practice address
2304 HANCOCK DR STE 1, AUSTIN, TX 78756-2537
(512) 454-0414
(512) 454-0426
Mailing address
2304 HANCOCK DR STE 1, AUSTIN, TX 78756-2537
(512) 454-0414
(512) 454-0426
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15791
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
825457
UNITED CONCORDIA
—
Enumeration date
08/31/2006
Last updated
08/22/2020
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