TINY TEETH, PC
Dentist at Research Blvd, Austin, TX

License number
Texas 28629
Category
Dentist
Type
Pediatric Dentistry
Owner
Name: DR. JAMIE L FAIRCHILD DMD
Title: OWNER
Phone: (208) 690-0366
Address
Address
11149 Research Blvd SUITE 270, Austin, TX 78759
National Provider ID: 1972946788
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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TINY TEETH, PC

Dallas, TX  -  Austin, TX

Industry:
Dentist's Office, Nonclassifiable Establishments
Registration:
Mar 19, 2013
Addresses:
2964 Lyndon B Johnson Fwy STE 414, Dallas, TX 75234 (Mailing)
11149 Research Blvd, Austin, TX 78759
State ID:
0801752133
Business type:
Domestic Professional Corporation
Directors:
Jamie L Fairchild (Director), 3202 Rocky Top Ln, Cedar Park, TX 78613,Braydon Fairchild Director, inactive
Agent:
Brayden J. Fairchild,11149 Research Blvd, Austin, TX 78759 (Physical)
TIN:
32050478380

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