| Gallatin Valley Pediatric Dentistry | |
|
115 W Kagy Blvd Suite C Bozeman MT 59715-6027 | |
| (406) 587-2327 | |
| (406) 587-3338 |
| Full Name | Gallatin Valley Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 115 W Kagy Blvd, Bozeman, Montana |
| Authorized Official Name and Position | Joel Sayre (CEO) |
| Authorized Official Contact | 4065999086 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gallatin Valley Pediatric Dentistry 115 W Kagy Blvd Suite C Bozeman MT 59715-6027 Ph: (406) 587-2327 | Gallatin Valley Pediatric Dentistry 115 W Kagy Blvd Suite C Bozeman MT 59715-6027 Ph: (406) 587-2327 |
| NPI Number | 1750507703 |
|---|---|
| Provider Enumeration Date | 04/18/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750507703 | NPI | - | NPPES |
| 0033436 | Medicaid | MT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 2212 (Montana) | Primary |
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