OrganizationSpecialty Pediatric Dentistry, PcDentistDental ProvidersPractice Address3313 Ranch Road 620 S Ste 300, Lakeway, TX 78738-6871(512) 266-7200PECOS EnrollmentBased on the most recent information from CMS, provider Specialty Pediatric Dentistry, Pc 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 ID1760186811Provider TypeOrganizationFull NameSpecialty Pediatric Dentistry, PcSubpartNoEnumeration Date3/30/2023Last Updated3/30/2023Contact InformationPractice LocationPractice Address3313 Ranch Road 620 S Ste 300, Lakeway, TX 78738-6871Phone(512) 266-7200Fax(512) 233-5180Mailing LocationMailing Address1500 S A W Grimes Blvd Ste 190, Round Rock, TX 78664-7843Phone(512) 266-7200Fax(512) 233-5180Authorized OfficialNameFields, Serenthes (Credentialing Specialist)Phone(678) 599-2333Provider TaxonomiesCodeDescriptionLicenseCode1223P0221XPrimaryDescriptionDentistDental ProvidersLicenseUnlisted Issuer