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General NPI Number Information
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NPI Number | 1700965134
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Entity Type | Individual
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Provider Name | MICHAEL TODD MONTGOMERY DDS
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Gender | Male
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Dates
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Enumeration Date | 11/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7551 CALLAGHAN RD #210
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City | SAN ANTONIO
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State | TX
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Zip | 78229-2860
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Country | US
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Telephone | 210-308-8228
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Fax | 210-308-5516
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Provider Business Mailing Address
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Address Line | 7551 CALLAGHAN RD #210
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City | SAN ANTONIO
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State | TX
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Zip | 78229-2860
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Country | US
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Telephone | 210-308-8228
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Fax | 210-308-5516
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 14958
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License Number State | TX
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