| Star Smiles Pediatric Dentistry | |
|
1103 Rivery Blvd Ste 140 Georgetown TX 78628-3034 | |
| (512) 864-9595 | |
| Not Available |
| Full Name | Star Smiles Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1103 Rivery Blvd, Georgetown, Texas |
| Authorized Official Name and Position | Kelly Marie Gonzales (PRESIDENT) |
| Authorized Official Contact | 5128649595 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Star Smiles Pediatric Dentistry 1103 Rivery Blvd Ste 140 Georgetown TX 78628-3034 Ph: (512) 864-9595 | Star Smiles Pediatric Dentistry 1103 Rivery Blvd Ste 140 Georgetown TX 78628-3034 Ph: (512) 864-9595 |
| NPI Number | 1801060660 |
|---|---|
| Provider Enumeration Date | 04/14/2008 |
| Last Update Date | 09/23/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801060660 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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