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General NPI Number Information
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NPI Number | 1750922126
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Entity Type | Organization
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Legal Business Name | MONTROSE DDS PLLC
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Dates
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Enumeration Date | 10/07/2019
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Last Update Date | 07/14/2020
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Provider Practice Location Address
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Address Line | 620 W ALABAMA ST
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City | HOUSTON
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State | TX
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Zip | 77006-5004
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Country | US
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Telephone | 713-529-4364
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Fax | 713-529-4337
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Provider Business Mailing Address
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Address Line | 620 W ALABAMA ST
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City | HOUSTON
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State | TX
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Zip | 77006-5004
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Country | US
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Telephone | 713-529-4364
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Fax | 713-529-4337
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | DR. SAMUEL CARRELL
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Credential | DDS
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Telephone | 713-529-4364
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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 |
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License Number State |
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