Tom Richard Lidahl, DMD is a
Dentist based in Plentywood, Montana. Tom Richard Lidahl is licensed to practice in Minnesota (license number D10463) and his current practice location is
223 N Main St, Plentywood, Montana. He can be reached at his office (for appointments etc.) via phone at
(406) 765-2700.
NPI number for Tom Richard Lidahl is 1720081201 and his current mailing address is 223 N Main St, Plentywood, Montana. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1720081201.
Healthcare Provider's Profile
| Full Name | Tom Richard Lidahl |
|---|
| Gender | Male |
|---|
| Speciality | Dentist |
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| Location | 223 N Main St, Plentywood, Montana |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1720081201
- Provider Enumeration Date: 05/27/2005
- Last Update Date: 07/09/2007
Medical Identifiers
Medical identifiers for Tom Richard Lidahl such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1720081201 | NPI | - | NPPES |
| 13274 | Other | MT | BCBS PROVIDER NUMBER |
| 5510244 | Other | MT | CHIP PROVIDER NUMBER |
| 991068 | Other | ND | BCBS PROVIDER NUMBER |
| 0116792 | Medicaid | MT | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223G0001X | Dentist - General Practice | 1327 (Montana) | Primary |
| 122300000X | Dentist | D10463 (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tom Richard Lidahl is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Tom Richard Lidahl, DMD
223 N Main St,
Plentywood, MT 59254-1843
Ph: (406) 765-2700 | Tom Richard Lidahl, DMD
223 N Main St,
Plentywood, MT 59254-1843
Ph: (406) 765-2700 |
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