Provider First Line Business Practice Location Address:
950 UNIVERSITY DR #101
Provider Second Line Business Practice Location Address:
LONGHORN DENTAL
Provider Business Practice Location Address City Name:
GEORGETOWN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78626
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-930-5930
Provider Business Practice Location Address Fax Number:
512-869-0276
Provider Enumeration Date:
08/26/2006