Missoula Pediatric Dentistry Pc
LBN: Missoula Pediatric Dentistry Pc
Missoula Pediatric Dentistry Pc is an health care organization with primary practice located at 1300 South Reserve St Suite B, Missoula MT 59801. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is the primary health care specialty.
Missoula Pediatric Dentistry Pc can be contacted via phone (406) 541-7334, or through Tiede, Paul Leonard via phone (406) 541-7334.
Contact Information
Primary practice address
1300 South Reserve St Suite B
Missoula MT 59801
Phone: (406) 541-7334
Fax: (406) 541-7338
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | MT2229 | Montana |
| Dental Providers / General Practice | 1223G0001X | MT2212 | Montana |
| Dental Providers / Pediatric Dentistry | 1223P0221X | MT2151 | Montana |
Profile Details
| NPI number | 1942483524 |
|---|---|
| LBN Legal business name | Missoula Pediatric Dentistry Pc |
| DBA Doing business as | |
| Authorized official | Tiede, Paul Leonard |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 6th, 2007 |
| Last updated | Jan 31st, 2014 - about 12 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942483524 | NPPES |
| Montana | MEDICAID | 1558308221 | |
| Montana | Other | 5512641 |
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