Organization
ATX DENTAL GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA GUTWEIN (OFFICE MANAGER)
(512) 340-6054
Entity
Organization
Contact information
Practice address
3100 S CONGRESS AVE # 1F, AUSTIN, TX 78704-6427
(512) 240-6054
Mailing address
3100 S CONGRESS AVE # 1F, AUSTIN, TX 78704-6427
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30301
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3509861-03
—
TX
Enumeration date
04/19/2016
Last updated
04/19/2016
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