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2900 Central Ave, Bldg1 Billings MT 59102-6686 | |
| (406) 656-6100 | |
| (406) 656-8726 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2900 Central Ave, Bldg1, Billings, Montana |
| Authorized Official Name and Position | Elgin Wade Wilde (OWNER) |
| Authorized Official Contact | 4066566100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2900 Central Ave, Bldg1 Billings MT 59102-6686 Ph: (406) 656-6100 | 2900 Central Ave, Bldg1 Billings MT 59102-6686 Ph: (406) 656-6100 |
| NPI Number | 1548410327 |
|---|---|
| Provider Enumeration Date | 09/29/2008 |
| Last Update Date | 12/29/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548410327 | NPI | - | NPPES |
| 113607 | Medicaid | MT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 1664 (Montana) | Primary |
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