# ELEVATION DENTAL DEER LODGE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063074524
- **Authorized official:** DR. PAUL K NIELSEN DDS (PRESIDENT)
- **Authorized official phone:** (406) 846-3532

## Contact information

- **Practice address:** 1101 MARYLAND AVE, DEER LODGE, MT 59722-1807
- **Practice address phone:** (406) 846-3532
- **Practice address fax:** (406) 846-1885
- **Mailing address:** 1101 MARYLAND AVE, DEER LODGE, MT 59722-1807
- **Mailing address phone:** (406) 846-3532
- **Mailing address fax:** (406) 846-1885

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/05/2019
- **Last updated:** 07/05/2019