Individual
DR. RONALD B POTTHOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
195 COMMONS LOOP STE A, KALISPELL, MT 59901-1912
(406) 755-5280
(406) 752-7679
Mailing address
195 COMMONS LOOP STE A, KALISPELL, MT 59901-1912
(406) 755-5280
(406) 752-7679
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1942
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111282
—
MT
01
—
40794
BLUE CROSS OF MT
MT
01
—
5510941
CHIPS
MT
Enumeration date
01/14/2007
Last updated
07/08/2007
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