| 406 Periodontics, Pllc | |
|
1648 Ellis St Ste 202 Bozeman MT 59715-8811 | |
| (406) 414-1303 | |
| (406) 577-2142 |
| Full Name | 406 Periodontics, Pllc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1648 Ellis St Ste 202, Bozeman, Montana |
| Authorized Official Name and Position | Jessica R Swoboda (OWNER/MEMBER) |
| Authorized Official Contact | 2069314221 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 406 Periodontics, Pllc 1648 Ellis St Ste 202 Bozeman MT 59715-8811 Ph: (206) 931-4221 | 406 Periodontics, Pllc 1648 Ellis St Ste 202 Bozeman MT 59715-8811 Ph: (406) 414-1303 |
| NPI Number | 1215655725 |
|---|---|
| Provider Enumeration Date | 08/19/2022 |
| Last Update Date | 08/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215655725 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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