Organization
CENTRAL TEXAS PERIODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN R CALLIA D.D.S., M.S. (DENTIST)
(512) 863-9500
Entity
Organization
Contact information
Practice address
1811 N. AUSTIN AVE., SUITE 101, GEORGETOWN, TX 78626
(512) 863-9500
(512) 863-9562
Mailing address
1811 N. AUSTIN AVE., SUITE 101, GEORGETOWN, TX 78626
(512) 863-9500
(512) 863-9562
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
20343
TX
Other
Enumeration date
04/24/2007
Last updated
09/08/2008
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