Provider Demographics
NPI:1619347804
Name:MONTANO & CARDALL ORTHODONTIC SPECIALISTS
Entity Type:Organization
Organization Name:MONTANO & CARDALL ORTHODONTIC SPECIALISTS
Other - Org Name:DONALD R. MONTANO DDS, MSD AND WES CARDALL DMD, MS A PROFESSIONAL CORP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ORTHODONTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:MONTANO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:661-428-0502
Mailing Address - Street 1:1010 CALLOWAY DR
Mailing Address - Street 2:#200A
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-6391
Mailing Address - Country:US
Mailing Address - Phone:661-665-7600
Mailing Address - Fax:661-665-7648
Practice Address - Street 1:1010 CALLOWAY DR
Practice Address - Street 2:#200A
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-6391
Practice Address - Country:US
Practice Address - Phone:661-665-7600
Practice Address - Fax:661-665-7648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-30
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADY0334981223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty