Organization
SMILES FOR SCHOOLS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDY TESCH R.D.H. (OWNER)
(512) 627-2668
Entity
Organization
Contact information
Practice address
902 CLEARWATER CIR, AUSTIN, TX 78753-2404
(512) 627-2668
Mailing address
902 CLEARWATER CIR, AUSTIN, TX 78753-2404
(512) 627-2668
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
9533
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130641707
—
TX
Enumeration date
10/25/2010
Last updated
10/25/2010
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