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General NPI Number Information
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NPI Number | 1306077458
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Entity Type | Organization
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Legal Business Name | TEXAS MOBILE DENTISTS, INC
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Dates
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Enumeration Date | 08/06/2009
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 5555 N LAMAR BLVD STE H125
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City | AUSTIN
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State | TX
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Zip | 78751
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Country | US
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Telephone | 512-861-1337
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Fax | 866-815-3719
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Provider Business Mailing Address
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Address Line | 5555 N LAMAR BLVD STE H125
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City | AUSTIN
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State | TX
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Zip | 78751
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Country | US
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Telephone | 866-988-4504
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Fax | 866-815-3719
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Authorized Official
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Title or Position | REVENUE CYCLE DIRECTOR
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Name | NICOLE BOLLINGER
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Credential |
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Telephone | 512-500-0302
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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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