| Sprout Oral Health | |
|
108 Village Downtown Blvd Bozeman MT 59715-3815 | |
| (406) 868-1549 | |
| Not Available |
| Full Name | Sprout Oral Health |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 108 Village Downtown Blvd, Bozeman, Montana |
| Authorized Official Name and Position | Jane Gillette (PRESIDENT) |
| Authorized Official Contact | 4068681549 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sprout Oral Health Po Box 1028 Bozeman MT 59771-1028 Ph: () - | Sprout Oral Health 108 Village Downtown Blvd Bozeman MT 59715-3815 Ph: (406) 868-1549 |
| NPI Number | 1700214350 |
|---|---|
| Provider Enumeration Date | 10/17/2013 |
| Last Update Date | 03/27/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700214350 | NPI | - | NPPES |
| 7115108 | Medicaid | MT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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