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Organization

LATCHED BEGINNINGS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KACIE MARIE CULOTTA DMD (OWNER)
(512) 814-7480
Entity
Organization

Contact information

Practice address
11671 JOLLYVILLE RD STE 204, AUSTIN, TX 78759-4141
(512) 814-7480
Mailing address
3106 DANCY ST, AUSTIN, TX 78722-2217
(512) 516-9240

Taxonomy

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

Other

Enumeration date
05/21/2024
Last updated
05/21/2024
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