Provider Demographics
NPI:1942871413
Name:CEDAR PARK COMFORT DENTISTRY PLLC
Entity Type:Organization
Organization Name:CEDAR PARK COMFORT DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RASHMI
Authorized Official - Middle Name:
Authorized Official - Last Name:INDRAKANTI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:404-435-0648
Mailing Address - Street 1:108 FAROLA CV
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-1790
Mailing Address - Country:US
Mailing Address - Phone:404-435-0028
Mailing Address - Fax:
Practice Address - Street 1:711 N BELL BLVD STE E
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2209
Practice Address - Country:US
Practice Address - Phone:512-335-0265
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty