Individual
ANGELA MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
392 FRONT ST, WEIR, MS 39772
(662) 547-5392
(662) 547-5107
Mailing address
PO BOX 278, WEIR, MS 39772
(662) 547-5392
(662) 547-5107
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
268692
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00660009
—
MS
Enumeration date
05/15/2007
Last updated
07/08/2007
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