| Lone Star Pediatric Dental | |
|
1015 W 34th St Austin TX 78705-2008 | |
| (512) 206-2929 | |
| Not Available |
| Full Name | Lone Star Pediatric Dental |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1015 W 34th St, Austin, Texas |
| Authorized Official Name and Position | Marty Montgomery (DENTIST/OWNER) |
| Authorized Official Contact | 5126764444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lone Star Pediatric Dental 505 E Huntland Dr Ste 340 Austin TX 78752-3745 Ph: () - | Lone Star Pediatric Dental 1015 W 34th St Austin TX 78705-2008 Ph: (512) 206-2929 |
| NPI Number | 1811343718 |
|---|---|
| Provider Enumeration Date | 05/10/2016 |
| Last Update Date | 05/10/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811343718 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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