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Organization
MICHAEL MONTGOMEY
Active
Organization
MICHAEL MONTGOMEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL MONTGOMERY DDS (OWNER)
(310) 821-0992
Entity
Organization
Contact information
Practice address
8055 W MANCHESTER AVE STE 500, PLAYA DEL REY, CA 90293-7965
(310) 821-0992
(310) 821-9027
Mailing address
8055 W MANCHESTER AVE STE 500, PLAYA DEL REY, CA 90293-7965
(310) 821-0992
(310) 821-9027
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
29383
CA
261QD0000X
Dental Clinic/Center
29383
CA
Other
Enumeration date
09/11/2017
Last updated
07/21/2022
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