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Organization

PRIME DENTAL OF CEDAR PARK PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DEEPAM TIWAN (MANAGER)
(512) 669-1291
Entity
Organization

Contact information

Practice address
821 W NEW HOPE DR STE 106, CEDAR PARK, TX 78613-2878
(512) 669-1291
Mailing address
821 W NEW HOPE DR STE 106, CEDAR PARK, TX 78613-2878

Taxonomy

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

Other

Enumeration date
10/24/2024
Last updated
10/24/2024
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