Provider Demographics
NPI:1538261318
Name:AUSTIN SMILE CENTER
Entity type:Organization
Organization Name:AUSTIN SMILE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-996-9990
Mailing Address - Street 1:11521 N FM 620
Mailing Address - Street 2:SUITE 700
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78726-1139
Mailing Address - Country:US
Mailing Address - Phone:512-506-9800
Mailing Address - Fax:512-506-9895
Practice Address - Street 1:11521 N FM 620
Practice Address - Street 2:SUITE 700
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78726-1139
Practice Address - Country:US
Practice Address - Phone:512-506-9800
Practice Address - Fax:512-506-9895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-02
Last Update Date:2008-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental