MEDICARE: JOAN L SEFCIK D.D.S

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	14891	TX

General Provider Information

NPI Number	:	1578712550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOAN L SEFCIK D.D.S

Provider Business Mailing Address
First Line	:	4014 MARATHON BLVD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78756-3718
Country	:	US
Telephone Number	:	512-453-6337
Fax Number	:	512-453-6937

Provider Business Practice Location Address
First Line	:	4014 MARATHON BLVD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78756-3718
Country	:	US
Telephone Number	:	512-453-6337
Fax Number	:	512-453-6937

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2008
Last Update Date	:	09/15/2008

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