# KOOTENAI FAMILY DENTISTRY

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

## Provider details

- **NPI number:** 1225274756
- **Authorized official:** DR. RONALD E. MENDENHALL DDS (OWNER)
- **Authorized official phone:** (406) 293-4116

## Contact information

- **Practice address:** 204 E 6TH ST, LIBBY, MT 59923-2052
- **Practice address phone:** (406) 293-4116
- **Practice address fax:** (406) 293-6645
- **Mailing address:** PO BOX 1379, LIBBY, MT 59923-1379
- **Mailing address phone:** (406) 293-4116
- **Mailing address fax:** (406) 293-6645

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 1984 | MT | Yes |

## Other

- **Enumeration date:** 01/06/2009
- **Last updated:** 01/06/2009