| 4405 Dental Studio | |
|
4405 Williams Dr Ste 300 Georgetown TX 78628-1383 | |
| (512) 855-7308 | |
| Not Available |
| Full Name | 4405 Dental Studio |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4405 Williams Dr Ste 300, Georgetown, Texas |
| Authorized Official Name and Position | Andrew Edmonds (OWNER/DOCTOR) |
| Authorized Official Contact | 5128557308 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 4405 Dental Studio 4405 Williams Dr Ste 300 Georgetown TX 78628-1383 | 4405 Dental Studio 4405 Williams Dr Ste 300 Georgetown TX 78628-1383 Ph: (512) 855-7308 |
| NPI Number | 1659846970 |
|---|---|
| Provider Enumeration Date | 10/13/2018 |
| Last Update Date | 04/27/2022 |
| Certification Date | 04/27/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659846970 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | () | Secondary |
| 261QD0000X | Clinic/center - Dental | () | Primary |
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