Individual
NICHOLAS BUMACOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5900 W SLAUGHTER LN STE 470C, AUSTIN, TX 78749-6513
(512) 288-1900
Mailing address
505 E HUNTLAND DR STE 340, AUSTIN, TX 78752-3745
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
33964
TX
Other
Enumeration date
03/30/2016
Last updated
12/07/2020
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