# QUEEN CITY DENTAL STUDIO

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

## Provider details

- **NPI number:** 1346691201
- **Authorized official:** DR. CHARISSA MICHELLE MARTIN DDS (DENTIST/OWNER)
- **Authorized official phone:** (406) 449-1300

## Contact information

- **Practice address:** 1300 N. MONTANA AVE, HELENA, MT 59601
- **Practice address phone:** (406) 449-1300
- **Practice address fax:** (406) 449-1311
- **Mailing address:** 1300 N MONTANA AVE, HELENA, MT 59601-3507
- **Mailing address phone:** (406) 461-4445

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2386 | MT | Yes |

## Other

- **Enumeration date:** 06/22/2016
- **Last updated:** 12/06/2019