Organization
LATIOLAIS KIMES DENTAL, PLLC
Active
Other names
Sage Dentistry Austin
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE E LATIOLAIS DDS (OWNER)
(512) 263-8500
Entity
Organization
Contact information
Practice address
11420 BEE CAVES RD, STE B150, AUSTIN, TX 78738-5526
(512) 263-8500
(512) 263-2866
Mailing address
11420 BEE CAVES RD, STE B150, AUSTIN, TX 78738-5526
(512) 263-8500
(512) 263-2866
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
24030
TX
Other
Enumeration date
04/29/2013
Last updated
04/29/2013
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