| |
625 Henry Chapple St. Billings MT 59106-1839 | |
(406) 259-7438 | |
(406) 259-9729 |
Full Name | |
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Speciality | Dentist |
Location | 625 Henry Chapple St., Billings, Montana |
Authorized Official Name and Position | Roderick M Griffeth (OWNER) |
Authorized Official Contact | 4062597438 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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625 Henry Chapple St Billings MT 59106-1839 Ph: (406) 259-7438 | 625 Henry Chapple St. Billings MT 59106-1839 Ph: (406) 259-7438 |
NPI Number | 1073656567 |
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Provider Enumeration Date | 02/14/2007 |
Last Update Date | 10/17/2022 |
Medicare PECOS PAC ID | 2961460258 |
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Medicare Enrollment ID | O20050103001050 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073656567 | NPI | - | NPPES |
112397100 | Medicaid | WY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
Provider Name | Roderick M Griffeth |
---|---|
Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1861727646 PECOS PAC ID: 7719165208 Enrollment ID: I20110705000471 |
Provider Name | Mackay J Hull |
---|---|
Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1184780421 PECOS PAC ID: 1658546924 Enrollment ID: I20111214001090 |
Provider Name | Bert W Winterholler |
---|---|
Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1841356094 PECOS PAC ID: 9830276823 Enrollment ID: I20111214001091 |
Provider Name | Brian R Ludwig |
---|---|
Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1083876478 PECOS PAC ID: 2567627755 Enrollment ID: I20120714000054 |
Provider Name | Jesse L Gray |
---|---|
Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1750678538 PECOS PAC ID: 1254563331 Enrollment ID: I20171024003704 |
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