Dr. Charles Robert Montgomery Jr., DDS
Dentist, General Practice in Jackson, NJ. Individual provider (NPI-1).
NPI number1720148745
StatusActive
Last updated in NPPESSep 17, 2012
Details
- NPI
- 1720148745
- Entity type
- Individual (NPI-1)
- Name
- Dr. Charles Robert Montgomery Jr.
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 11, 2006
- Last updated
- Sep 17, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | di01679400 | NJ | Yes |
Practice location
302 Mackenzie DrJackson, NJ 08527-1184
Phone 732-901-9036
Mailing address
302 Mackenzie DrJackson, NJ 08527-1184
Phone 732-901-9036
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