| My Local Texas Dental Practice, Pllc | |
| 
					111 N Vista Ridge Blvd Ste 100 Cedar Park TX 78613-2425  | |
| (512) 250-2356 | |
| Not Available | 
| Full Name | My Local Texas Dental Practice, Pllc | 
|---|---|
| Speciality | Dentist - General Practice | 
| Location | 111 N Vista Ridge Blvd Ste 100, Cedar Park, Texas | 
| Authorized Official Name and Position | Gregory Kostelac (DATA ANALYST) | 
| Authorized Official Contact | 7193725605 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| My Local Texas Dental Practice, Pllc 6110 Barnes Rd Colorado Springs CO 80922-2600 Ph: () -  | My Local Texas Dental Practice, Pllc 111 N Vista Ridge Blvd Ste 100 Cedar Park TX 78613-2425 Ph: (512) 250-2356  | 
| NPI Number | 1588303275 | 
|---|---|
| Provider Enumeration Date | 06/01/2022 | 
| Last Update Date | 06/01/2022 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1588303275 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary | 
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