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General NPI Number Information
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NPI Number | 1962650234
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Entity Type | Organization
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Legal Business Name | NEWKIRK&MONTGOMERY,LLC
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Dates
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Enumeration Date | 08/28/2008
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Last Update Date | 08/28/2008
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Provider Practice Location Address
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Address Line | 22250 S SALAMO RD
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City | WEST LINN
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State | OR
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Zip | 97068-7206
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Country | US
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Telephone | 503-656-9331
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Fax | 503-656-9391
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Provider Business Mailing Address
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Address Line | 22250 S SALAMO RD
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City | WEST LINN
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State | OR
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Zip | 97068-7206
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Country | US
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Telephone | 503-656-9331
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Fax | 503-656-9391
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Authorized Official
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Title or Position | SECRETARY
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Name | DR. MARK W MONTGOMERY
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Credential | DMD
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Telephone | 503-656-9331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 5678
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License Number State | OR
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