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General NPI Number Information
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NPI Number | 1225663628
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Entity Type | Organization
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Legal Business Name | MISHKA DENTAL PLLC
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Dates
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Enumeration Date | 03/05/2020
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Last Update Date | 03/05/2020
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Provider Practice Location Address
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Address Line | 531 ED SCHMIDT BLVD SUITE # 100 SUITE # 100
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City | HUTTO
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State | TX
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Zip | 78634
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Country | US
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Telephone | 512-886-2644
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Fax | 512-886-2645
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Provider Business Mailing Address
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Address Line | 605 PUERTA VALLARTA LN
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City | AUSTIN
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State | TX
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Zip | 78748-4068
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Country | US
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Telephone | 216-240-0329
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Fax |
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Authorized Official
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Title or Position | GENERAL DENTIST / OWNER
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Name | PRASHANT PAREKH
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Credential | DDS
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Telephone | 512-886-2644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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