| Full Care Dental Pllc | |
|
690 Sw Higgins Ave Ste E Missoula MT 59803-1433 | |
| (406) 543-3777 | |
| (406) 543-6205 |
| Full Name | Full Care Dental Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 690 Sw Higgins Ave Ste E, Missoula, Montana |
| Authorized Official Name and Position | Timothy M Lawhorn (OWNER, DENTIST) |
| Authorized Official Contact | 4065433777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Full Care Dental Pllc 690 Sw Higgins Ave Ste E Missoula MT 59803-1433 Ph: (406) 543-3777 | Full Care Dental Pllc 690 Sw Higgins Ave Ste E Missoula MT 59803-1433 Ph: (406) 543-3777 |
| NPI Number | 1174653372 |
|---|---|
| Provider Enumeration Date | 03/06/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174653372 | NPI | - | NPPES |
| 0110903 | Medicaid | MT | |
| 5512828 | Other | MT | CHIP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 1744 (Montana) | Primary |
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