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701 State Park Rd Lockhart TX 78644-4934 | |
| (512) 398-3429 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 701 State Park Rd, Lockhart, Texas |
| Authorized Official Name and Position | Gregory Kostelac (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 7193725605 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6110 Barnes Rd Colorado Springs CO 80922-2600 Ph: () - | 701 State Park Rd Lockhart TX 78644-4934 Ph: (512) 398-3429 |
| NPI Number | 1689334518 |
|---|---|
| Provider Enumeration Date | 12/20/2021 |
| Last Update Date | 07/26/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689334518 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Gail Gardner Livengood Dds, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 701 State Park Rd, Lockhart, TX 78644 Phone: 512-398-3429 Fax: 512-398-2233 | |
Lockhart Smile Center Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 308 S Main St, Lockhart, TX 78644 Phone: 512-398-6122 | |
My Local Texas Dental Practice, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 701 State Park Rd, Lockhart, TX 78644 Phone: 512-398-4934 |