Provider Demographics
NPI:1689354912
Name:AFFORDABLE DENTURES & IMPLANTS - TEXAS, PLLC
Entity Type:Organization
Organization Name:AFFORDABLE DENTURES & IMPLANTS - TEXAS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENROLLMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:HALEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-733-8551
Mailing Address - Street 1:2530 WALSH TARLTON LN STE 210
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-7782
Mailing Address - Country:US
Mailing Address - Phone:512-402-5872
Mailing Address - Fax:
Practice Address - Street 1:2530 WALSH TARLTON LN STE 210
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-7782
Practice Address - Country:US
Practice Address - Phone:512-402-5872
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty