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Organization
MAIN STREET
Active
Organization
MAIN STREET
Active
Other names
Lost Pines Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY BARTLEY (BUSINESS MANAGER)
(512) 985-7535
Entity
Organization
Contact information
Practice address
812 CHESTNUT ST, BASTROP, TX 78602-3205
(512) 253-4977
Mailing address
812 CHESTNUT ST, BASTROP, TX 78602-3205
(512) 253-4977
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
05/06/2021
Last updated
07/15/2026
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