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Individual
DR. JAMES R KOLSTAD
Active
Individual
DR. JAMES R KOLSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2216
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0115050
—
MT
01
—
22164
BLUE CROSS BLUE SHIELD OF
MT
01
—
5513105
CHIPS
MT
Enumeration date
02/20/2007
Last updated
07/08/2007
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