Herzog Austin Domain PC

NPI #1609209105 in Austin, Texas

Provider Information

NPI Number: 1609209105
Entity Type: Organization
Organization Name: Herzog Austin Domain PC
Primary Specialty: Dentist
Enumeration Date: Aug 20, 2013
Last Updated: Aug 20, 2013

Practice Location

Address: 3310 W. BRAKER LN BLD. 1 #100
City: Austin
State: Texas
ZIP Code: 78758
Phone: (512) 617-0110

Authorized Official

Name: CORTNEY BLACK
Title: MANAGER
Phone: (512) 617-0110

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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