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NPI Code Detail

MEDICARE: ROSS B. MADDOX DDS

MEDICARE:   ROSS B. MADDOX  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
1122300000XDentist27311TX

General Provider Information

NPI Number : 1740568302
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSS B. MADDOX DDS
Provider Business Mailing Address
First Line : 9000 ANDERSON MILL RD
Second Line :
City : AUSTIN
State : TX
Zip : 78729-4501
Country : US
Telephone Number : 512-331-9088
Fax Number : 512-918-9017
Provider Business Practice Location Address
First Line : 9000 ANDERSON MILL RD
Second Line :
City : AUSTIN
State : TX
Zip : 78729-4501
Country : US
Telephone Number : 512-331-9088
Fax Number : 512-918-9017
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2011
Last Update Date : 08/01/2011

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Directions to “ ROSS B. MADDOX DDS” Practice Location

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