Organization
RISING STARS ORTHO LAKELINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SERENTHES FIELDS (CREDENTIALING SPECIALIST)
(407) 684-3738
Entity
Organization
Contact information
Practice address
14005 US 183, SUITE 800, AUSTIN, TX 78717
(512) 266-7200
Mailing address
10824 E CRYSTAL FALLS PKWY STE 203, LEANDER, TX 78641-4301
(512) 266-7200
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
09/15/2023
Last updated
09/15/2023
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