Provider Demographics
NPI:1356806855
Name:FRONTAGE RSVS PLLC
Entity type:Organization
Organization Name:FRONTAGE RSVS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABTAHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-493-1216
Mailing Address - Street 1:STE. A1, 3909 N INTERSTATE 35 FRONTAGE RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78722
Mailing Address - Country:US
Mailing Address - Phone:214-493-1216
Mailing Address - Fax:
Practice Address - Street 1:STE. A1, 3909 N INTERSTATE 35 FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78722
Practice Address - Country:US
Practice Address - Phone:214-493-1216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-08
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty