Organization
MICHELLE L. FREEZE, DMD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELLE L FREEZE DMD (OWNER, PEDIATRIC DENTIST)
(512) 266-7200
Entity
Organization
Contact information
Practice address
4308 N. QUINLAN PARK RD, STE 201, AUSTIN, TX 78732
(512) 266-7200
(512) 266-6197
Mailing address
10900 LAKELINE MALL DR, STE 250, AUSTIN, TX 78717
(512) 266-7200
(512) 583-0675
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
21635
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1620639
UNITED CONCORDIA
TX
Enumeration date
03/26/2007
Last updated
08/22/2020
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