Provider Demographics
NPI:1023625407
Name:WOODFIELD, AUSTIN KEITH (DMD)
Entity type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:KEITH
Last Name:WOODFIELD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 E ELMS RD
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-2810
Mailing Address - Country:US
Mailing Address - Phone:254-519-4700
Mailing Address - Fax:
Practice Address - Street 1:1405 E ELMS RD
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-2810
Practice Address - Country:US
Practice Address - Phone:254-519-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39943122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist