NPI 1972926699

Lakeline Ranch Dental

Organisation Preferred Provider Organization Austin, TX

Practice location

Address: 10900 Lakeline Mall Dr Suite 250, Austin, TX 78717-5924
Phone: (512) 583-0700
Fax: (512) 583-0700

Authorised official

Name: Ardalan Zahedi
Title: Owner
Phone: (512) 583-0700

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 25493 (TX)

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Registry record

NPI: 1972926699
Entity type: Organization
NPI issued: 31 Jan 2014
Record last updated: 31 Jan 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.