Organization
LONE STAR PEDIATRIC DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTY R MONTGOMERY DMD (OWNER)
(512) 442-4338
Entity
Organization
Contact information
Practice address
2700 S 1ST ST, AUSTIN, TX 78704-5421
(512) 442-4338
(512) 442-6074
Mailing address
2700 S 1ST ST, AUSTIN, TX 78704-5421
(512) 442-4338
(512) 442-6074
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
24217
TX
Other
Enumeration date
06/24/2010
Last updated
06/24/2010
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