Provider Demographics
NPI:1659447001
Name:MONTGOMERY, RACHEL EUBANK (DDS)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:EUBANK
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-5421
Mailing Address - Country:US
Mailing Address - Phone:832-755-6458
Mailing Address - Fax:
Practice Address - Street 1:2700 S 1ST ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-5421
Practice Address - Country:US
Practice Address - Phone:832-755-6458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21598122300000X, 1223P0221X
PADS0374191223P0221X
TX223641223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist