Pecan Street Dental

NPI #1558813030 in Bastrop, Texas

Provider Information

NPI Number: 1558813030
Entity Type: Organization
Organization Name: Pecan Street Dental
Primary Specialty: Dentist
Enumeration Date: Oct 31, 2016
Last Updated: Oct 31, 2016

Practice Location

Address: 708 PECAN ST
City: Bastrop
State: Texas
ZIP Code: 78602-3816
Phone: (512) 321-2188

Authorized Official

Name: DR. KEVIN DEUTSCH
Title: OWNER
Phone: (512) 321-2188

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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