| NPI | 1376854364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTY R MONTGOMERY Owner 512-442-4338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 24217) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2010-06-24 |