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Organization
CONNIE L SMALL, DDS, PLLC
Active
Organization
CONNIE L SMALL, DDS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE L SMALL DDS (OWNER)
(406) 755-4127
Entity
Organization
Contact information
Practice address
673 1ST AVENUE WEST N, KALISPELL, MT 59901-3607
(406) 755-4127
Mailing address
673 1ST AVENUE WEST N, KALISPELL, MT 59901-3607
(406) 755-4127
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1758
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0115124
—
MT
05
—
112115
—
MT
Enumeration date
05/03/2007
Last updated
08/22/2020
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