Provider Demographics
NPI:1396121810
Name:DAVID C MONTZ DDS PA
Entity type:Organization
Organization Name:DAVID C MONTZ DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-485-4829
Mailing Address - Street 1:2443 S GALVESTON AVE
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-4222
Mailing Address - Country:US
Mailing Address - Phone:281-485-4829
Mailing Address - Fax:
Practice Address - Street 1:2443 S GALVESTON AVE
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-4222
Practice Address - Country:US
Practice Address - Phone:281-485-4829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-06
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BC3200X
TX18724122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1952314882OtherNPI