Missoula Peditric Dentistry, P.c. | |
3020 S Reserve St Ste D Missoula MT 59801-7652 | |
(406) 541-7334 | |
(406) 541-7338 |
Full Name | Missoula Peditric Dentistry, P.c. |
---|---|
Speciality | Dentist - Pediatric Dentistry |
Location | 3020 S Reserve St Ste D, Missoula, Montana |
Authorized Official Name and Position | Paul Leonard Tiede (BUSINESS MANAGER) |
Authorized Official Contact | 4065417334 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Missoula Peditric Dentistry, P.c. 3020 S Reserve St Ste D Missoula MT 59801-7652 Ph: (406) 541-7334 | Missoula Peditric Dentistry, P.c. 3020 S Reserve St Ste D Missoula MT 59801-7652 Ph: (406) 541-7334 |
NPI Number | 1205183852 |
---|---|
Provider Enumeration Date | 08/13/2012 |
Last Update Date | 08/13/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1205183852 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | 4170 (Montana) | Primary |
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