Blavatsky, Elizabeth

Blavatsky, Elizabeth is an individual health care provider with primary practice located at 422 S Main St , Livingston MT 59047-3456. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Blavatsky, Elizabeth can be contacted via phone (406) 222-6061.

Contact Information

Primary practice address
422 S Main St Livingston MT 59047-3456
Fax: (406) 222-6062
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 1835 Montana

Profile Details

NPI number 1679627699
LBN Legal business name Blavatsky, Elizabeth
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679627699 NPPES
Montana MEDICAID 0130624
Montana Other 5511051

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