| Austin Dental Care | |
|
4419 Frontier Trl Ste 104 Austin TX 78745-1567 | |
| (512) 444-1133 | |
| (512) 445-0552 |
| Full Name | Austin Dental Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 4419 Frontier Trl Ste 104, Austin, Texas |
| Authorized Official Name and Position | Evan Matthysse (SOLE OWNER) |
| Authorized Official Contact | 5124441133 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Austin Dental Care 4419 Frontier Trl Ste 104 Austin TX 78745-1567 Ph: (512) 444-1133 | Austin Dental Care 4419 Frontier Trl Ste 104 Austin TX 78745-1567 Ph: (512) 444-1133 |
| NPI Number | 1699503375 |
|---|---|
| Provider Enumeration Date | 07/23/2024 |
| Last Update Date | 07/23/2024 |
| Medicare PECOS PAC ID | 9830638469 |
|---|---|
| Medicare Enrollment ID | O20240828000190 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699503375 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Evan Matthysse |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1205296803 PECOS PAC ID: 9234497306 Enrollment ID: I20240828000176 |
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