Provider Demographics
NPI:1902991938
Name:CUSTER, SYLVIA H (DDS)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:H
Last Name:CUSTER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4005 SPICEWOOD SPRINGS RD
Mailing Address - Street 2:SUITE B-300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8666
Mailing Address - Country:US
Mailing Address - Phone:512-346-3780
Mailing Address - Fax:512-346-3781
Practice Address - Street 1:4005 SPICEWOOD SPRINGS RD
Practice Address - Street 2:SUITE B-300
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8666
Practice Address - Country:US
Practice Address - Phone:512-346-3780
Practice Address - Fax:512-346-3781
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX127361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice