| Shine Pediatric Dental Co. | |
|
2631 Gattis School Rd Round Rock TX 78664-2821 | |
| (512) 698-8766 | |
| Not Available |
| Full Name | Shine Pediatric Dental Co. |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2631 Gattis School Rd, Round Rock, Texas |
| Authorized Official Name and Position | Sarah Severson (OWNER) |
| Authorized Official Contact | 5126988766 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shine Pediatric Dental Co. 608 Twelve Oaks Ln Austin TX 78704-6355 | Shine Pediatric Dental Co. 2631 Gattis School Rd Round Rock TX 78664-2821 Ph: (512) 698-8766 |
| NPI Number | 1548977895 |
|---|---|
| Provider Enumeration Date | 11/04/2022 |
| Last Update Date | 11/04/2022 |
| Certification Date | 11/04/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548977895 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | () | Primary |
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