# SMILE MISSOULA PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1225306749
- **Authorized official:** DR. GEORGE M. OLSEN DDS (PRESIDENT)
- **Authorized official phone:** (406) 721-2830

## Contact information

- **Practice address:** 237 SW HIGGINS AVE, STE C, MISSOULA, MT 59803-1485
- **Practice address phone:** (406) 721-2830
- **Mailing address:** 300 BEN HOGAN DR, MISSOULA, MT 59803-2419
- **Mailing address phone:** (406) 721-2830
- **Mailing address fax:** (406) 549-5053

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 1424 | MT | Yes |
| 1223G0001X | General Practice Dentistry | 2474 | MT | — |

## Other

- **Enumeration date:** 12/12/2011
- **Last updated:** 02/24/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1101-62 | — | MT |
| 01 | — | 5511480 | CHIP | MT |