| Jollyville Dental Professionals | |
|
11672 Jollyville Rd Austin TX 78759-3935 | |
| (512) 918-0005 | |
| (512) 918-0008 |
| Full Name | Jollyville Dental Professionals |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 11672 Jollyville Rd, Austin, Texas |
| Authorized Official Name and Position | Bruce Dee Roach (OWNER/DENTIST) |
| Authorized Official Contact | 5129180005 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jollyville Dental Professionals 11672 Jollyville Rd Austin TX 78759-3935 Ph: (512) 918-0005 | Jollyville Dental Professionals 11672 Jollyville Rd Austin TX 78759-3935 Ph: (512) 918-0005 |
| NPI Number | 1417155417 |
|---|---|
| Provider Enumeration Date | 07/11/2007 |
| Last Update Date | 07/11/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417155417 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 13219 (Texas) | Primary |
Jared Poplin D.m.d., Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6850 Austin Center Blvd Ste 220, Austin, TX 78731 Phone: 785-691-6171 | |
Ac Dentistry Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 13616 N Highway 183, Austin, TX 78750 Phone: 512-682-5437 | |