# RIDDLE MONTGOMERY METHENY DDS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Family Dental Practice Inc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134284714
- **Authorized official:** DR. ROBERT A MONTGOMERY DDS (DENTIST MANAGER SECRETARY)
- **Authorized official phone:** (304) 636-1100

## Contact information

- **Practice address:** 108 THIRD ST, ELKINS, WV 26241
- **Practice address phone:** (304) 636-1100
- **Practice address fax:** (304) 636-0066
- **Mailing address:** 108 THIRD ST, ELKINS, WV 26241
- **Mailing address phone:** (304) 636-1100
- **Mailing address fax:** (304) 636-0066

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | W3576 | WV | — |
| 122300000X | Dentist | WV2192 | WV | — |
| 122300000X | Dentist | WV2960 | WV | Yes |
| 122300000X | Dentist | WV3367 | WV | — |

## Other

- **Enumeration date:** 12/26/2006
- **Last updated:** 08/22/2020