# CONNIE L SMALL, DDS, PLLC

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

## Provider details

- **NPI number:** 1861614182
- **Authorized official:** CONNIE L SMALL DDS (OWNER)
- **Authorized official phone:** (406) 755-4127

## Contact information

- **Practice address:** 673 1ST AVENUE WEST N, KALISPELL, MT 59901-3607
- **Practice address phone:** (406) 755-4127
- **Mailing address:** 673 1ST AVENUE WEST N, KALISPELL, MT 59901-3607
- **Mailing address phone:** (406) 755-4127

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 1758 | MT | Yes |

## Other

- **Enumeration date:** 05/03/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0115124 | — | MT |
| 05 | — | 112115 | — | MT |