Individual
JOHN MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
18924 FREEPORT DRIVE, SUITE A, MONTGOMERY, TX 77356
(936) 582-4396
(936) 582-4311
Mailing address
18924 FREEPORT DRIVE, SUITE A, MONTGOMERY, TX 77356
(936) 582-4396
(936) 582-4311
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13113
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84D226
BLUE CROSS BLUE SHIELD OF
SD
Enumeration date
08/30/2006
Last updated
07/08/2007
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