Individual
MAKENZIE NICOLE BAGNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
33 DOC KIMBALL WAY, BIGFORK, MT 59911-6491
(406) 614-2020
Mailing address
33 DOC KIMBALL WAY, BIGFORK, MT 59911-6491
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN-DEN-LIC-23639
MT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/14/2022
Last updated
10/10/2024
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