| Missoula Peditric Dentistry, P.c. | |
|
3020 S Reserve St Ste D Missoula MT 59801-7652 | |
| (406) 541-7334 | |
| (406) 541-7338 |
| Full Name | Missoula Peditric Dentistry, P.c. |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 3020 S Reserve St Ste D, Missoula, Montana |
| Authorized Official Name and Position | Paul Leonard Tiede (BUSINESS MANAGER) |
| Authorized Official Contact | 4065417334 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Missoula Peditric Dentistry, P.c. 3020 S Reserve St Ste D Missoula MT 59801-7652 Ph: (406) 541-7334 | Missoula Peditric Dentistry, P.c. 3020 S Reserve St Ste D Missoula MT 59801-7652 Ph: (406) 541-7334 |
| NPI Number | 1205183852 |
|---|---|
| Provider Enumeration Date | 08/13/2012 |
| Last Update Date | 08/13/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205183852 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 4170 (Montana) | Primary |
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