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General NPI Number Information
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NPI Number | 1124513742
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Entity Type | Organization
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Legal Business Name | OAK HILL DENTAL
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Dates
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Enumeration Date | 06/26/2018
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Last Update Date | 06/26/2018
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Provider Practice Location Address
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Address Line | 7101 W HIGHWAY 71 STE A3
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City | AUSTIN
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State | TX
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Zip | 78735-8352
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Country | US
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Telephone | 512-551-5400
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Fax | 512-551-5408
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Provider Business Mailing Address
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Address Line | 7101 W HIGHWAY 71 STE A3
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City | AUSTIN
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State | TX
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Zip | 78735-8352
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Country | US
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Telephone | 512-551-5400
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Fax | 512-551-5408
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. LUISA ANNA CANTU
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Credential |
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Telephone | 512-551-5400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 28457
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License Number State | TX
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