| NPI | 1104364710 |
|---|---|
| Doing Business As | LONE STAR PEDIATRIC DENTAL |
| Entity Type | Organization |
| Authorized Contact | MARTY MONTGOMERY Owner 512-206-2975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2017-02-02 |
| Last Update Date | 2017-02-02 |