Provider Demographics
NPI:1306317227
Name:TW RAWCLIFFE DENTAL, PLLC
Entity type:Organization
Organization Name:TW RAWCLIFFE DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:RAWCLIFFE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-643-6104
Mailing Address - Street 1:1900 UNIVERSITY BLVD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665
Mailing Address - Country:US
Mailing Address - Phone:512-643-6104
Mailing Address - Fax:
Practice Address - Street 1:1900 UNIVERSITY BLVD
Practice Address - Street 2:SUITE 180
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-7866
Practice Address - Country:US
Practice Address - Phone:512-643-6104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental