| Mt Oms Specialty Dental Services, Pllc | |
|
152 S 32nd St W Ste B Billings MT 59102-6875 | |
| (406) 245-4414 | |
| Not Available |
| Full Name | Mt Oms Specialty Dental Services, Pllc |
|---|---|
| Speciality | Dentist |
| Location | 152 S 32nd St W Ste B, Billings, Montana |
| Authorized Official Name and Position | Charlotte Dasch (DIRECTOR OF PROVIDER RELATIONS) |
| Authorized Official Contact | 5046380303 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mt Oms Specialty Dental Services, Pllc 1610 54th Ave N Nashville TN 37209-1401 Ph: (504) 638-0303 | Mt Oms Specialty Dental Services, Pllc 152 S 32nd St W Ste B Billings MT 59102-6875 Ph: (406) 245-4414 |
| NPI Number | 1255007589 |
|---|---|
| Provider Enumeration Date | 08/17/2021 |
| Last Update Date | 06/06/2023 |
| Medicare PECOS PAC ID | 7911391933 |
|---|---|
| Medicare Enrollment ID | O20220308000682 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255007589 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Andrew G Boyce |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1336282458 PECOS PAC ID: 3678668779 Enrollment ID: I20071004000414 |
| Provider Name | Kyle Tracy |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1225357734 PECOS PAC ID: 7517106164 Enrollment ID: I20150105000421 |
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