Provider Demographics
NPI:1336473636
Name:TRUEBLOOD DENTAL ASSOCIATES
Entity Type:Organization
Organization Name:TRUEBLOOD DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TRUEBLOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-892-7200
Mailing Address - Street 1:6705 W HIGHWAY 290
Mailing Address - Street 2:C1
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-8400
Mailing Address - Country:US
Mailing Address - Phone:512-892-7200
Mailing Address - Fax:512-892-7205
Practice Address - Street 1:5339 N IH 35
Practice Address - Street 2:100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-2428
Practice Address - Country:US
Practice Address - Phone:512-892-7200
Practice Address - Fax:512-892-7205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty