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3031 Grand Ave #198 Billings MT 59102 | |
| (406) 855-0844 | |
| (406) 969-6659 |
| Full Name | |
|---|---|
| Speciality | Dentist - Dentist Anesthesiologist |
| Location | 3031 Grand Ave #198, Billings, Montana |
| Authorized Official Name and Position | Ryan K. Larsen (PRESIDENT) |
| Authorized Official Contact | 4068550844 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3031 Grand Ave #198 Billings MT 59102 Ph: (801) 360-2353 | 3031 Grand Ave #198 Billings MT 59102 Ph: (406) 855-0844 |
| NPI Number | 1306258991 |
|---|---|
| Provider Enumeration Date | 05/29/2014 |
| Last Update Date | 10/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306258991 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0004X | Dentist - Dentist Anesthesiologist | 7687 (Montana) | Primary |
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