Ideal Dental South Park Meadows Pllc

NPI #1457246050 in Austin, Texas

Provider Information

NPI Number: 1457246050
Entity Type: Organization
Organization Name: Ideal Dental South Park Meadows Pllc
Primary Specialty: Dentist
Enumeration Date: Jun 12, 2025
Last Updated: Jun 12, 2025

Practice Location

Address: 200 W SLAUGHTER LANE
Address 2: STE 103
City: Austin
State: Texas
ZIP Code: 78748
Phone: (512) 271-9396

Authorized Official

Name: CAROL CANAVA
Title: VP REVENUE CYCLE
Phone: (972) 331-8079

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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