Organization
LONE STAR CIRCLE OF CARE
Active
Other names
Lone Star Circle of Care at Georgetown Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN DAVID CALVIN (CEO)
(512) 994-1933
Entity
Organization
Contact information
Practice address
2411 WILLIAMS DR, SUITE 111, GEORGETOWN, TX 78628-3271
(877) 800-5722
(512) 864-1447
Mailing address
2423 WILLIAMS DR STE 107, GEORGETOWN, TX 78628-3269
(877) 800-5722
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1560575-03
—
TX
Enumeration date
05/11/2006
Last updated
05/12/2025
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