Organization
LSPD AT CIRCLE C, PLLC
Active
Other names
Lone Star Pediatric Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MARTY MONTGOMERY DMD (OWNER)
(512) 206-2975
Entity
Organization
Contact information
Practice address
5900 W SLAUGHTER LN STE 470, AUSTIN, TX 78749-6513
(512) 206-2929
Mailing address
505 E HUNTLAND DR STE 340, AUSTIN, TX 78752-3745
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
02/02/2017
Last updated
02/02/2017
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