Organization
RISING STARS PEDIATRIC DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELLE L FREEZE DMD (PEDIATRIC DENTIST)
(512) 266-7200
Entity
Organization
Contact information
Practice address
4308 N QUINLAN PARK, STE 201, AUSTIN, TX 78732
(512) 266-7200
(512) 266-6197
Mailing address
4308 N QUINLAN PARK, STE 201, AUSTIN, TX 78732
(512) 266-7200
(512) 266-6197
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1620639
UNITED CONCORDIA
—
Enumeration date
09/06/2006
Last updated
07/17/2008
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