| NPI | 1861615536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH MONTGOMERY COE Owner 281-259-5444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 16174) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2020-08-22 |