Provider Demographics
NPI:1013125558
Name:8118 DENTAL PROFESSIONALS PLLC
Entity Type:Organization
Organization Name:8118 DENTAL PROFESSIONALS PLLC
Other - Org Name:8118 DENTAL PROFESSIONALS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELWARD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:512-452-8262
Mailing Address - Street 1:8118 SHOAL CREEK
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757
Mailing Address - Country:US
Mailing Address - Phone:512-452-8262
Mailing Address - Fax:512-420-8265
Practice Address - Street 1:8118 SHOAL CREEK
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757
Practice Address - Country:US
Practice Address - Phone:512-452-8262
Practice Address - Fax:512-420-8265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15389122300000X
TX9068122300000X
122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty