| Lone Star Circle Of Care At Georgetown Dental | |
|
2411 Williams Dr Suite 111 Georgetown TX 78628-3271 | |
| (877) 800-5722 | |
| (512) 864-1447 |
| Full Name | Lone Star Circle Of Care At Georgetown Dental |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 2411 Williams Dr, Georgetown, Texas |
| Authorized Official Name and Position | Jonathan David Calvin (CEO) |
| Authorized Official Contact | 5129941933 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lone Star Circle Of Care At Georgetown Dental 205 E University Ave Suite 200 Georgetown TX 78626-6814 Ph: (512) 686-0207 | Lone Star Circle Of Care At Georgetown Dental 2411 Williams Dr Suite 111 Georgetown TX 78628-3271 Ph: (877) 800-5722 |
| NPI Number | 1639129331 |
|---|---|
| Provider Enumeration Date | 05/11/2006 |
| Last Update Date | 09/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639129331 | NPI | - | NPPES |
| 1560575-03 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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