TATE MONTGOMERY

EDMOND, OK
NPI1255575502
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223D0004X Dentist, Dentist Anesthesiologist Speciality
(Licence: OK  6231)
Additional Taxonomies122300000X Dentist
(Licence: OK  6231)
122300000X Dentist
(Licence: CA  58243)
122300000X Dentist
(Licence: KS  60643)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2009-04-29
Last Update Date2015-04-02
Business Address
-- TATE MONTGOMERY DDS
3824 S BOULEVARD STE 110
EDMOND, OK 73013-5779
Phone number: 918-200-9610
Mailing Address
-- TATE MONTGOMERY DDS
PO BOX 30
SAPULPA, OK 74067-0030
Phone number: 918-200-9610