Organization
KYLE RAYMOND PA
Active
Other names
Westlake Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMERA TORRES (CREDENTIALING SPECIALIST)
(512) 809-4162
Entity
Organization
Contact information
Practice address
5656 BEE CAVES RD STE B104, AUSTIN, TX 78746
(512) 732-0022
Mailing address
5656 BEE CAVES RD STE B104, AUSTIN, TX 78746
(512) 732-0022
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
18034
TX
Other
Enumeration date
04/30/2014
Last updated
05/05/2014
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