| Connie L Small, Dds, Pllc | |
|
673 1st Avenue West N Kalispell MT 59901-3607 | |
| (406) 755-4127 | |
| Not Available |
| Full Name | Connie L Small, Dds, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 673 1st Avenue West N, Kalispell, Montana |
| Authorized Official Name and Position | Connie L Small (OWNER) |
| Authorized Official Contact | 4067554127 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Connie L Small, Dds, Pllc 673 1st Avenue West N Kalispell MT 59901-3607 Ph: (406) 755-4127 | Connie L Small, Dds, Pllc 673 1st Avenue West N Kalispell MT 59901-3607 Ph: (406) 755-4127 |
| NPI Number | 1861614182 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861614182 | NPI | - | NPPES |
| 0115124 | Medicaid | MT | |
| 112115 | Medicaid | MT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 1758 (Montana) | Primary |
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