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Organization

NORTH AUSTIN PEDIATRIC DENTAL, PLLC

Active
Other names
Lone Star Pediatric Dental
Organization subpart
No

Provider details

NPI number
Authorized official
MARTY MONTGOMERY DMD (PRESIDENT)
(512) 574-6923
Entity
Organization

Contact information

Practice address
8716 RESEARCH BLVD # 125, AUSTIN, TX 78758-6420
(512) 454-4646
(512) 419-0561
Mailing address
8716 RESEARCH BLVD # 125, AUSTIN, TX 78758-6420
(512) 454-4646
(512) 419-0561

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
24217
TX

Other

Enumeration date
10/24/2012
Last updated
10/24/2012
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