| Prairie Star Dental | |
|
1900 University Blvd Suite 180 Round Rock TX 78665-7866 | |
| (512) 643-6104 | |
| Not Available |
| Full Name | Prairie Star Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1900 University Blvd, Round Rock, Texas |
| Authorized Official Name and Position | Thomas Rawcliffe (PRESIDENT) |
| Authorized Official Contact | 5126436104 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie Star Dental 1900 University Blvd Suite 180 Round Rock TX 78665 Ph: (512) 643-6104 | Prairie Star Dental 1900 University Blvd Suite 180 Round Rock TX 78665-7866 Ph: (512) 643-6104 |
| NPI Number | 1306317227 |
|---|---|
| Provider Enumeration Date | 12/17/2018 |
| Last Update Date | 12/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306317227 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | () | Primary |
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