Provider Demographics
NPI:1093212151
Name:ENAMEL DENTISTRY PARMER PARK, PLLC
Entity Type:Organization
Organization Name:ENAMEL DENTISTRY PARMER PARK, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARDIK
Authorized Official - Middle Name:
Authorized Official - Last Name:CHODAVADIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-988-6484
Mailing Address - Street 1:3108 E 51ST ST UNIT 1004
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-0007
Mailing Address - Country:US
Mailing Address - Phone:817-988-6484
Mailing Address - Fax:
Practice Address - Street 1:1606 E. PARMER LN
Practice Address - Street 2:SUITE #125
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753
Practice Address - Country:US
Practice Address - Phone:817-988-6484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-06
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty