# TATE MONTGOMERY DDS PLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Heartland Anesthesia
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396090791
- **Authorized official:** DR. TATE MONTGOMERY DDS (OWNER)
- **Authorized official phone:** (918) 200-9610

## Contact information

- **Practice address:** 911 N RIDGEWAY ST, SAPULPA, OK 74066-2417
- **Practice address phone:** (918) 200-9610
- **Practice address fax:** (918) 200-9610
- **Mailing address:** 911 N RIDGEWAY ST, SAPULPA, OK 74066-2417
- **Mailing address phone:** (918) 200-9610
- **Mailing address fax:** (918) 200-9610

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 6231 | OK | Yes |

## Other

- **Enumeration date:** 07/22/2012
- **Last updated:** 07/22/2012