Gallatin Valley Maxillofacial & Aesthetic Surgery | |
1994 Stadium Dr Bozeman MT 59715-0655 | |
(406) 587-0767 | |
(406) 587-2120 |
Full Name | Gallatin Valley Maxillofacial & Aesthetic Surgery |
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Speciality | Dentist - Oral And Maxillofacial Surgery |
Location | 1994 Stadium Dr, Bozeman, Montana |
Authorized Official Name and Position | Brian R. Chisdak (OWNER) |
Authorized Official Contact | 4065870767 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Gallatin Valley Maxillofacial & Aesthetic Surgery 1994 Stadium Dr Bozeman MT 59715-0655 Ph: (406) 587-0767 | Gallatin Valley Maxillofacial & Aesthetic Surgery 1994 Stadium Dr Bozeman MT 59715-0655 Ph: (406) 587-0767 |
NPI Number | 1992355929 |
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Provider Enumeration Date | 09/11/2019 |
Last Update Date | 09/11/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1992355929 | NPI | - | NPPES |
1689745804 | Other | NPI | |
1457573727 | Other | MT | NPI |
1336301266 | Other | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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