Provider Demographics
NPI:1508270166
Name:TWINSCA, PLLC
Entity Type:Organization
Organization Name:TWINSCA, PLLC
Other - Org Name:TOWN CENTER DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:MOMIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-740-1435
Mailing Address - Street 1:6280 MCNEIL DR
Mailing Address - Street 2:APT 513
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-6982
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:905 E WHITESTONE BLVD
Practice Address - Street 2:STE D
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-9096
Practice Address - Country:US
Practice Address - Phone:512-670-8880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX272331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty