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General NPI Number Information
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NPI Number | 1427761196
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Entity Type | Organization
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Legal Business Name | FOUR POINTS DENTAL GROUP PLLC
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Dates
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Enumeration Date | 12/27/2022
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Last Update Date | 12/27/2022
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Provider Practice Location Address
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Address Line | 7301 N FM 620 RD STE 150
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City | AUSTIN
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State | TX
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Zip | 78726-4538
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Country | US
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Telephone | 512-872-2222
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Fax | 512-250-2902
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Provider Business Mailing Address
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Address Line | 7301 N FM 620 RD STE 150
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City | AUSTIN
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State | TX
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Zip | 78726-4538
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Country | US
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Telephone | 512-872-2222
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Fax | 512-250-2902
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | TRACI LEANN WALDSCHMIDT
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Credential |
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Telephone | 254-722-1083
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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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