# MOLLY R GANNON D D S P C

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

## Provider details

- **NPI number:** 1639416738
- **Authorized official:** DR. MOLLY R GANNON DDS (OWNER)
- **Authorized official phone:** (406) 363-1211

## Contact information

- **Practice address:** 512 OLD CORVALLIS RD, HAMILTON, MT 59840-3131
- **Practice address phone:** (406) 363-1211
- **Practice address fax:** (406) 363-1212
- **Mailing address:** 512 OLD CORVALLIS RD, HAMILTON, MT 59840-3131
- **Mailing address phone:** (406) 363-1211
- **Mailing address fax:** (406) 363-1212

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 2066 | MT | Yes |

## Other

- **Enumeration date:** 01/09/2013
- **Last updated:** 01/09/2013