Provider Demographics
NPI:1871992339
Name:BRETT STRONG
Entity type:Organization
Organization Name:BRETT STRONG
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:STRONG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-608-3789
Mailing Address - Street 1:1830 ROUND ROCK AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-4021
Mailing Address - Country:US
Mailing Address - Phone:512-341-7373
Mailing Address - Fax:512-341-8907
Practice Address - Street 1:1830 ROUND ROCK AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4021
Practice Address - Country:US
Practice Address - Phone:512-341-7373
Practice Address - Fax:512-341-8907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22545261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental