My Local Texas Dental Practice, Pllc

NPI #1598425266 in Buda, Texas

Provider Information

NPI Number: 1598425266
Entity Type: Organization
Organization Name: My Local Texas Dental Practice, Pllc
Subpart: Yes (part of a larger organization)
Parent Organization: MY LOCAL TEXAS DENTAL PRACTICE, PLLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Dec 22, 2021
Last Updated: Dec 22, 2021

Practice Location

Address: 1671 MAIN ST STE B
City: Buda
State: Texas
ZIP Code: 78610-9732
Phone: (512) 295-5777

Authorized Official

Name: GREGORY KOSTELAC
Title: CREDENTIALING SPECIALIST
Phone: (719) 372-5605

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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