MEDICARE: DR. GREGG E UECKERT D.D.S.

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	332B00000X	Durable Medical Equipment & Medical Supplies
2	122300000X	Dentist	17663	TX

General Provider Information

NPI Number	:	1881607091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGG E UECKERT D.D.S.

Provider Business Mailing Address
First Line	:	7030 VILLAGE CENTER DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78731-3024
Country	:	US
Telephone Number	:	512-345-3166
Fax Number	:	512-345-0162

Provider Business Practice Location Address
First Line	:	7030 VILLAGE CENTER DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78731-3024
Country	:	US
Telephone Number	:	512-345-3166
Fax Number	:	512-345-0162

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

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	11/18/2020

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