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Shouvik Ponnusamy, DMD
Oral and Maxillofacial Surgery (Dentist) in Round Rock, Texas
NPI 1457706202

Shouvik Ponnusamy is a Oral and Maxillofacial Surgery (Dentist) based in Cedar Park, TX and is specialized in Oral and Maxillofacial Surgery. Shouvik Ponnusamy practices in Round Rock, TX and has the professional credentials of DMD. The NPI Number for Shouvik Ponnusamy is 1457706202 and holds a License No. (Texas).

The current practice location address for Shouvik Ponnusamy is 4010 Sandy Brook Dr Ste 204, Round Rock, TX and can be reached out via phone at 512-456-3161. You can also correspond with Shouvik Ponnusamy through the mailing address at 1511 RIMSTONE DR, CEDAR PARK, TX - 78613-7692 (mailing address contact number: 630-267-1199).

Location: 4010 Sandy Brook Dr Ste 204, Round Rock, TX, 78613-7692
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1457706202
Provider Name
Shouvik Ponnusamy
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
4010 Sandy Brook Dr Ste 204, Round Rock, TX, 78613-7692
Phone Number
512-456-3161
Fax Number
Provider Enumeration Date
04/29/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
4010 Sandy Brook Dr Ste 204
City
Round Rock
State
Texas
Zip
78665-1518
Phone Number
512-456-3161
Fax Number
person
Provider Business Mailing Address Details
Address
1511 Rimstone Dr
City
Cedar Park
State
Texas
Zip
78613-7692
Phone Number
630-267-1199
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
1223S0112X
License No.
38050 (Texas)
Definition
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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