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General NPI Number Information
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NPI Number | 1932558343
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Entity Type | Organization
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Legal Business Name | LOVING PEDIATRIC DENTISTRY PLLC
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Dates
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Enumeration Date | 06/07/2016
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Last Update Date | 06/07/2016
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Provider Practice Location Address
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Address Line | 7800 N MOPAC EXPY SUITE 110
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City | AUSTIN
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State | TX
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Zip | 78759-8900
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Country | US
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Telephone | 512-710-8250
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Fax |
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Provider Business Mailing Address
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Address Line | 7800 N MOPAC EXPY SUITE 110
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City | AUSTIN
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State | TX
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Zip | 78759-8900
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Country | US
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Telephone | 512-710-8250
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Fax |
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Authorized Official
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Title or Position | MANAGER/ OWNER
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Name | DR. BRANDY L LOVING
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Credential | DDS
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Telephone | 210-957-9268
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 22312
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License Number State | TX
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