Individual
SOPHIA GRACE MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1801 W WISCONSIN AVE, MILWAUKEE, WI 53233-2186
(414) 288-6790
Mailing address
1801 W WISCONSIN AVE, MILWAUKEE, WI 53233-2186
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
6001946
WI
Other
Enumeration date
08/26/2025
Last updated
08/26/2025
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