Organization
GROOVY MOLAR, P.L.L.C.
Active
Other names
Groovy Molar Pediatric Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRAD C SINGLETON DDS (OWNER)
(512) 810-1378
Entity
Organization
Contact information
Practice address
3410 FAR WEST BLVD, SUITE 310, AUSTIN, TX 78731-3194
(512) 810-1378
Mailing address
3410 FAR WEST BLVD, SUITE 310, AUSTIN, TX 78731-3194
(512) 810-1378
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
21128
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
170979201
—
TX
05
—
174254602
—
TX
Enumeration date
05/25/2010
Last updated
05/25/2010
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