| Summit Oral Surgery & Implant Center | |
|
625 Henry Chapple St. Billings MT 59106-1839 | |
| (406) 259-7438 | |
| (406) 259-9729 |
| Full Name | Summit Oral Surgery & Implant Center |
|---|---|
| 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 |
|---|---|
| Summit Oral Surgery & Implant Center 625 Henry Chapple St Billings MT 59106-1839 Ph: (406) 259-7438 | Summit Oral Surgery & Implant Center 625 Henry Chapple St. Billings MT 59106-1839 Ph: (406) 259-7438 |
| NPI Number | 1073656567 |
|---|---|
| Provider Enumeration Date | 02/14/2007 |
| Last Update Date | 10/17/2022 |
| Medicare PECOS PAC ID | 2961460258 |
|---|---|
| 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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