| Lone Star Pediatric Dental | |
|
1015 West 34th St. Austin TX 78705 | |
| (512) 206-2929 | |
| (512) 206-2920 |
| Full Name | Lone Star Pediatric Dental |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1015 West 34th St., Austin, Texas |
| Authorized Official Name and Position | Marty Montgomery (OWNER) |
| Authorized Official Contact | 5122062975 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lone Star Pediatric Dental 505 E Huntland Dr. #340 Austin TX 78752 Ph: (512) 206-2975 | Lone Star Pediatric Dental 1015 West 34th St. Austin TX 78705 Ph: (512) 206-2929 |
| NPI Number | 1437437639 |
|---|---|
| Provider Enumeration Date | 07/22/2011 |
| Last Update Date | 12/30/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437437639 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 24217 (Texas) | Primary |
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