Provider Demographics
NPI:1699869107
Name:SPRING BRANCH DENTAL CARE
Entity type:Organization
Organization Name:SPRING BRANCH DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BREN
Authorized Official - Middle Name:MONTGOMERY
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:830-438-7444
Mailing Address - Street 1:20475 HIGHWAY 46 WEST
Mailing Address - Street 2:
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070
Mailing Address - Country:US
Mailing Address - Phone:830-438-7444
Mailing Address - Fax:830-438-7112
Practice Address - Street 1:20475 HIGHWAY 46 WEST
Practice Address - Street 2:
Practice Address - City:SPRING BRANCH
Practice Address - State:TX
Practice Address - Zip Code:78070
Practice Address - Country:US
Practice Address - Phone:830-438-7444
Practice Address - Fax:830-438-7112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX147911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty