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Organization

BRUK P. WEYMOUTH, DDS, PC

Active
Other names
Family Dental Center
Organization subpart
No

Provider details

NPI number
Authorized official
PENNY WEYMOUTH (OFFICE MANAGER)
(406) 727-1006
Entity
Organization

Contact information

Practice address
3224 10TH AVE S, GREAT FALLS, MT 59405-3449
(406) 727-1006
(406) 727-1008
Mailing address
PO BOX 7050, GREAT FALLS, MT 59406-7050
(406) 727-1006
(406) 727-1008

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
1786
MT
1223G0001X
General Practice Dentistry
Primary
2091
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0112659
MT
05
0112829
MT
01
5512284
DR BOLLWITT CHIP ID#
MT
01
5512386
DR WEYMOUTH CHIP ID #
MT
Enumeration date
01/15/2007
Last updated
04/14/2008
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