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Organization
SUTHERLIN DENTAL
Active
Organization
SUTHERLIN DENTAL
Active
Other names
Monte' E. Montgomery DDS, PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MONTE' ERELL MONTGOMERY D.D.S. (PRESIDENT)
(541) 459-4612
Entity
Organization
Contact information
Practice address
115 N STATE ST, SUTHERLIN, OR 97479-9807
(541) 459-4612
(541) 459-4911
Mailing address
PO BOX 719, SUTHERLIN, OR 97479-0719
(541) 459-4612
(541) 459-4911
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D6919
OR
Other
Enumeration date
01/06/2009
Last updated
01/06/2009
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