Provider Demographics
NPI:1063523009
Name:IMPERIAL, ARTHUR PATRICK (DDS, PC)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:PATRICK
Last Name:IMPERIAL
Suffix:
Gender:M
Credentials:DDS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5114 BALCONES WOODS DR STE 308
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5212
Mailing Address - Country:US
Mailing Address - Phone:512-346-1900
Mailing Address - Fax:512-346-2272
Practice Address - Street 1:5114 BALCONES WOODS DR STE 308
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5212
Practice Address - Country:US
Practice Address - Phone:512-346-1900
Practice Address - Fax:512-346-2272
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX172851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice