| Montana Childrens Dentistry Pllc | |
|
116 Glacier Dr Ste 107 Lolo MT 59847-9343 | |
| (702) 339-7274 | |
| Not Available |
| Full Name | Montana Childrens Dentistry Pllc |
|---|---|
| Speciality | Dentist |
| Location | 116 Glacier Dr Ste 107, Lolo, Montana |
| Authorized Official Name and Position | Steven Delisle (OWNER) |
| Authorized Official Contact | 7023397274 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Montana Childrens Dentistry Pllc 116 Glacier Dr Ste 107 Lolo MT 59847-9343 Ph: () - | Montana Childrens Dentistry Pllc 116 Glacier Dr Ste 107 Lolo MT 59847-9343 Ph: (702) 339-7274 |
| NPI Number | 1326706201 |
|---|---|
| Provider Enumeration Date | 12/07/2021 |
| Last Update Date | 12/07/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326706201 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
Lolo Dental Clinic Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 108 Tyler Way, Lolo, MT 59847 Phone: 406-273-0490 Fax: 406-273-7969 |