Organization
LSPD AT COVE PLLC
Active
Other names
Lone Star Pediatric Dental and Braces
Organization subpart
No
Provider details
NPI number
Authorized official
MARTY MONTGOMERY DMD (DMD/OWNER)
(512) 676-4444
Entity
Organization
Contact information
Practice address
2705 E HWY 190, SUITE 101, COPPERAS COVE, TX 76522
(512) 676-4444
Mailing address
505 E HUNTLAND DR #340, AUSTIN, TX 78752
(512) 206-2975
(512) 371-8779
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
02/08/2019
Last updated
02/08/2019
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