Individual
DR. DEAN W CALDERWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
125 NUCLEUS AVE, COLUMBIA FALLS, MT 59912-4010
(406) 892-2104
(406) 892-1422
Mailing address
275 BAD ROCK DR, COLUMBIA FALLS, MT 59912-9211
(406) 892-3702
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1607
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0111293
—
MT
01
—
1607
STATE LICENSE NUMBER
MT
Enumeration date
04/04/2007
Last updated
07/08/2007
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