Organization
KATHRYN K MONTGOMERY DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHRYN K MONTGOMERY DDS (OWNER)
(937) 642-1151
Entity
Organization
Contact information
Practice address
15580 US RT 36E, MARYSVILLE, OH 43040
(937) 642-1151
Mailing address
15580 US RT 36E, MARYSVILLE, OH 43040
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30022373
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1770793069
NPI INDIVIDUAL
OH
Enumeration date
01/18/2011
Last updated
01/18/2011
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