MEDICARE: DR. DAVID BRINKLEY DDS, MS

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	1223G0001X	General Practice Dentistry	20370	TX

General Provider Information

NPI Number	:	1699702688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID BRINKLEY DDS, MS

Provider Business Mailing Address
First Line	:	2630 EXPOSITION BLVD
Second Line	:	STE G-01
City	:	AUSTIN
State	:	TX
Zip	:	78703-1700
Country	:	US
Telephone Number	:	512-477-5100
Fax Number	:

Provider Business Practice Location Address
First Line	:	2630 EXPOSITION BLVD
Second Line	:	STE G-01
City	:	AUSTIN
State	:	TX
Zip	:	78703-1700
Country	:	US
Telephone Number	:	512-477-5100
Fax Number	:

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

Provider Enumeration Date	:	06/27/2006
Last Update Date	:	07/08/2007

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