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Organization
MIDDLEBURY DENTAL GROUP
Active
Organization
MIDDLEBURY DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM RODERICK MONTGOMERY DMD (OWNER/DENTIST)
(802) 388-3553
Entity
Organization
Contact information
Practice address
1330 EXCHANGE ST, MIDDLEBURY, VT 05753-4425
(802) 388-3553
(802) 388-7377
Mailing address
1330 EXCHANGE ST, MIDDLEBURY, VT 05753-4425
(802) 388-3553
(802) 388-7377
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0300X
Periodontics
—
—
Other
Enumeration date
08/17/2006
Last updated
01/05/2010
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