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General NPI Number Information
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NPI Number | 1841783255
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Entity Type | Individual
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Provider Name | ADRIENNE RHODES MONTGOMERY DDS
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Gender | Female
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Dates
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Enumeration Date | 06/11/2018
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Last Update Date | 08/22/2018
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Provider Practice Location Address
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Address Line | 2600 JAMES RD STE 100
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City | GRANBURY
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State | TX
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Zip | 76049
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Country | US
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Telephone | 817-326-4098
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Fax |
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Provider Business Mailing Address
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Address Line | 207 SHADE TREE LN # LM
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City | CLEBURNE
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State | TX
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Zip | 76033-1138
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Country | US
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Telephone | 817-240-9052
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Fax |
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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 | 34177
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License Number State | TX
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