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General NPI Number Information
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NPI Number | 1285893651
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Entity Type | Organization
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Legal Business Name | CENTRAL FAMILY DENTAL CENTER
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Dates
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Enumeration Date | 06/02/2008
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Last Update Date | 06/02/2008
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Provider Practice Location Address
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Address Line | 2719 E 7TH ST
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City | AUSTIN
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State | TX
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Zip | 78702-3907
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Country | US
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Telephone | 512-473-8444
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Fax |
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Provider Business Mailing Address
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Address Line | 39 HEDGEBROOK WAY
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City | THE HILLS
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State | TX
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Zip | 78738-1319
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Country | US
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Telephone | 512-261-4676
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAN NECKER
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Credential | D.D.S.
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Telephone | 512-473-8444
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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 | 14426
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License Number State | TX
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