MEDICARE: DR. ANNE MARIE CLINE DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	5435	OK

General Provider Information

NPI Number	:	1083761811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNE MARIE CLINE DDS

Provider Business Mailing Address
First Line	:	619 TURQUOISE DR
Second Line	:
City	:	DRIPPING SPRINGS
State	:	TX
Zip	:	78620-2194
Country	:	US
Telephone Number	:	337-401-2307
Fax Number	:

Provider Business Practice Location Address
First Line	:	3001 S LAMAR BLVD STE 100
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-4794
Country	:	US
Telephone Number	:	512-442-0101
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	11/24/2020

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