OrganizationLakeway Pediatric Dental, Pllc(Lone Star Pediatric Dental)DentistDental ProvidersPractice Address14058 Bee Caves Pkwy, Bldg. D. Suite B, Austin, TX 78738(512) 402-9996(512) 206-2975PECOS EnrollmentBased on the most recent information from CMS, provider Lakeway Pediatric Dental, Pllc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:47 AM.Profile DetailsProvider ID1346539996Provider TypeOrganizationFull NameLakeway Pediatric Dental, PllcOther NameLone Star Pediatric DentalSubpartNoEnumeration Date4/5/2011Last Updated12/30/2016Contact InformationPractice LocationPractice Address14058 Bee Caves Pkwy, Bldg. D. Suite B, Austin, TX 78738Phone(512) 402-9996Fax(512) 402-9986Mailing LocationMailing Address505 E Huntland Dr., #340, Austin, TX 78752Phone(512) 206-2975Fax(512) 371-8779Authorized OfficialNameMontgomery, Marty (Owner)Phone(512) 206-2975Provider TaxonomiesCodeDescriptionLicenseCode1223P0221XPrimaryDescriptionDentistDental ProvidersLicenseUnlisted Issuer