# MONTANA ROOTS DENTAL CARE PLLC

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

## Provider details

- **NPI number:** 1164935573
- **Authorized official:** BRANDI M TRUESDELL (OFFICE MANAGER)
- **Authorized official phone:** (406) 442-0282

## Contact information

- **Practice address:** 2744 COLONIAL DR, HELENA, MT 59601-4947
- **Practice address phone:** (406) 442-0282
- **Mailing address:** 2744 COLONIAL DR, HELENA, MT 59601-4947
- **Mailing address phone:** (406) 442-0282

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 2455 | MT | Yes |
| 261QD0000X | Dental Clinic/Center | 2455 | MT | — |

## Other

- **Enumeration date:** 11/07/2017
- **Last updated:** 11/15/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2455 | LICENSE | MT |