| NPI | 1770838146 |
|---|---|
| Doing Business As | LONESTAR PERIODONTICS |
| Entity Type | Organization |
| Authorized Contact | ALICIA POWELL Office Manager 512-453-1600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: TX 20329) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: TX 22581) |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2012-07-20 |