Organization Name: | LAKE POINTE DENTAL ASSOCIATES, PA |
NPI Number: | 1003111295 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | HOLLY M MURPHY (DENTIST/OWNER) |
Mailing Address: | 11612 Fm 2244 Building 2, Suite 155 Austin |
State: | TX US |
Postal Code: | 787385409 |
Phone Number: | 5122637896 |
Fax Number: | 5122638005 |
NPI Enumeration Date: | 01/19/2011 |
NPI Last Update Date: | 01/19/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | 22902 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |