| Lonestar Periodontics | |
|
711 W 38th St Ste G5 Austin TX 78705-1121 | |
| (512) 453-1600 | |
| (512) 453-1503 |
| Full Name | Lonestar Periodontics |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 711 W 38th St, Austin, Texas |
| Authorized Official Name and Position | Christopher Mark Bingaham (OWNER) |
| Authorized Official Contact | 5124531600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lonestar Periodontics 711 W 38th St Ste G5 Austin TX 78705 Ph: (512) 453-1600 | Lonestar Periodontics 711 W 38th St Ste G5 Austin TX 78705-1121 Ph: (512) 453-1600 |
| NPI Number | 1962833996 |
|---|---|
| Provider Enumeration Date | 12/02/2013 |
| Last Update Date | 12/02/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962833996 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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