Organization
SPECIALTY ORTHODONTICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SERENTHES FIELDS (CREDENTIALING SPECIALIST)
(512) 271-4001
Entity
Organization
Contact information
Practice address
608 GATEWAY CENTRAL STE 201, MARBLE FALLS, TX 78654-6356
(512) 271-4001
(512) 233-5180
Mailing address
1500 S A W GRIMES BLVD STE 190, ROUND ROCK, TX 78664-7843
(512) 271-4001
(512) 233-5180
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
03/30/2023
Last updated
03/30/2023
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