# PETER IVEY LLC

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

## Provider details

- **NPI number:** 1689437436
- **Authorized official:** DR. PETER IVEY DDS (OWNER)
- **Authorized official phone:** (530) 277-3607

## Contact information

- **Practice address:** 555 CORPORATE DR STE 204, KALISPELL, MT 59901-6138
- **Practice address phone:** (530) 277-3607
- **Practice address fax:** (406) 309-6141
- **Mailing address:** 511 4TH AVE E, KALISPELL, MT 59901-4914
- **Mailing address phone:** (530) 277-3607

## Taxonomy

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

## Other

- **Enumeration date:** 02/05/2024
- **Last updated:** 06/20/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 193400000X | — | MT |