Individual
RYAN L MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3012 GREEN MEADOW DRIVE, SAN ANGELO, TX 76904-2262
(502) 777-9016
Mailing address
5122 BEVERLY DR, SAN ANGELO, TX 76904
(502) 777-9016
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
29483
TX
Other
Enumeration date
03/22/2009
Last updated
08/26/2016
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