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General NPI Number Information
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NPI Number | 1396088654
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Entity Type | Organization
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Legal Business Name | GUTIERREZ FAMILY DENTAL PLLC
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Dates
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Enumeration Date | 04/04/2013
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Last Update Date | 04/04/2013
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Provider Practice Location Address
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Address Line | 8740 N LAMAR BLVD SUITE 202
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City | AUSTIN
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State | TX
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Zip | 78753-5440
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Country | US
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Telephone | 512-835-7725
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Fax | 512-835-2840
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Provider Business Mailing Address
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Address Line | 8740 N LAMAR BLVD SUITE 202
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City | AUSTIN
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State | TX
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Zip | 78753-5440
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Country | US
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Telephone | 512-835-7725
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Fax | 512-835-2840
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Authorized Official
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Title or Position | MEMBER
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Name | DR. ADRIANA LAPAYRA-GUTIERREZ
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Credential | D.D.S.
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Telephone | 512-835-7725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 23729
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License Number State | TX
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