MEDICARE: BUDA FAMILY DENTISTRY PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1285119057
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUDA FAMILY DENTISTRY PLLC

Provider Business Mailing Address
First Line	:	3420B FM967
Second Line	:	STEB-105
City	:	BUDA
State	:	TX
Zip	:	78610
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3420B FM967
Second Line	:	STEB-105
City	:	BUDA
State	:	TX
Zip	:	78610-7861
Country	:	US
Telephone Number	:	512-810-0714
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. PAVITHRA SWAMI
Credential	:	DDS
Telephone Number	:	512-810-0714

Provider Enumeration Date	:	09/27/2018
Last Update Date	:	09/27/2018

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Directions to “BUDA FAMILY DENTISTRY PLLC ” Practice Location

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