Individual
DR. CHARLES ROBERT MONTGOMERY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
302 MACKENZIE DR, JACKSON, NJ 08527-1184
(732) 901-9036
Mailing address
302 MACKENZIE DR, JACKSON, NJ 08527-1184
(732) 901-9036
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DI01679400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1263706
—
NJ
Enumeration date
12/11/2006
Last updated
09/17/2012
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