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Individual

DR. MARSHALL BRADY MONTGOMERY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
850 PURCHASE ST, NEW BEDFORD, MA 02740-6232
(508) 992-6553
(508) 999-5457
Mailing address
874 PURCHASE ST, NEW BEDFORD, MA 02740-6232
(508) 984-7031
(508) 984-7034

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
DEN03099
RI
122300000X
Dentist
Primary
DN1855260
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110087629A
MA
Enumeration date
06/16/2009
Last updated
09/28/2011
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