| NPI | 1487239455 |
|---|---|
| Doing Business As | MONTGOMERY PARK DENTAL |
| Entity Type | Organization |
| Authorized Contact | CAROLYN L. JOVANOVIC Dentist 936-756-6867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2021-03-11 |
| Last Update Date | 2023-08-18 |