MEDICARE: RONALD MONTGOMERY DENTAL GROUP, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1740355205
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RONALD MONTGOMERY DENTAL GROUP, PC

Provider Business Mailing Address
First Line	:	PO BOX 872710
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98687-2710
Country	:	US
Telephone Number	:	360-869-7645
Fax Number	:	877-725-7443

Provider Business Practice Location Address
First Line	:	7001 N MAY AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73116-3248
Country	:	US
Telephone Number	:	405-843-6200
Fax Number	:	405-843-6210

Authorized Official
Title or Position	:	PC OWNER
Name	:	DR. RONALD K MONTGOMERY
Credential	:	DDS
Telephone Number	:	405-689-1003

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	08/22/2025

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