| Meadowlark Dental Care Pllc | |
|
628 South Ave W Suite B Missoula MT 59801-8020 | |
| (406) 543-0300 | |
| Not Available |
| Full Name | Meadowlark Dental Care Pllc |
|---|---|
| Speciality | Dentist |
| Location | 628 South Ave W, Missoula, Montana |
| Authorized Official Name and Position | Cyrus Michael Larson (PRESIDENT) |
| Authorized Official Contact | 4065430300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Meadowlark Dental Care Pllc 628 South Ave W Suite B Missoula MT 59801-8020 Ph: (406) 543-0300 | Meadowlark Dental Care Pllc 628 South Ave W Suite B Missoula MT 59801-8020 Ph: (406) 543-0300 |
| NPI Number | 1841648227 |
|---|---|
| Provider Enumeration Date | 05/26/2016 |
| Last Update Date | 05/26/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841648227 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 9630 (Montana) | Primary |
| 122300000X | Dentist | 1739 (Montana) | Secondary |
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