Leslie Edward Broline in Austin - Periodontics
Leslie Edward Broline - NPI 1154427029
Leslie Edward Broline is a Periodontics in Austin, Texas. Leslie Edward Broline practices all healthcare services and medical treatments related to Periodontics. The NPI Number for Leslie Edward Broline is 1154427029. The last update date is 2007-07-08.
Leslie Edward Broline's current location address is 3508 Far West Blvd, Austin, Texas. You can contact this provider via phone number 5123439488 and fax number 5123431062. The mailing address for Leslie Edward Broline is 3508 Far West Blvd, Austin, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Leslie Edward Broline |
|---|---|
| Address | 3508 Far West Blvd, Austin, Texas |
| Phone Number | 5123439488 |
| Fax Number | 5123431062 |
| Sole Proprietor | N |
| Credentials | DDS MS |
NPI Number Detail
| NPI Number | 1154427029 |
|---|---|
| Provider Enumeration Date | 2006-09-16 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 3508 Far West Blvd |
|---|---|
| City | Austin |
| State | Texas (TX) |
| Post Code | 787313041 |
| Phone Number | 5123439488 |
| Fax Number | 5123431062 |
Provider's Primary Taxonomy Detail
| Speciality | Periodontics |
|---|---|
| Taxonomy | 1223P0300X |
| Licence No | 9766 |
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Definition: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structure |
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What is the Leslie Edward Broline's unique identification number?
The Leslie Edward Broline has been assigned the NPI (National Provider Identifier) Number 1154427029 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you share the physical location details of Leslie Edward Broline?
The Leslie Edward Broline is situated at 3508 Far West Blvd, in the city of Austin, state of TX, with the zip code 787313041.
What is Leslie Edward Broline's specialized field of practice, and what is the corresponding taxonomy classification code?
The Leslie Edward Broline's area of specialization is Periodontics, and the corresponding taxonomy code that categorizes this field of practice is 1223P0300X.
When was the Leslie Edward Broline's 1154427029 issued?
The Leslie Edward Broline's 1154427029 was issued on 2006-09-16.
As of what date were the Leslie Edward Broline's details last updated?
The information pertaining to the Leslie Edward Broline, including its address, specialty, and other details, was most recently updated on 2007-07-08.
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