Individual
DR. GREGORY ALLAN ZLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1211 S RESERVE ST, SUITE 201, MISSOULA, MT 59801-3101
(406) 543-6320
(406) 541-6307
Mailing address
1211 S RESERVE ST, SUITE 201, MISSOULA, MT 59801-3101
(406) 543-6320
(406) 541-6307
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2075
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0130000
—
MT
01
—
5512923
CHIP
MT
Enumeration date
12/15/2006
Last updated
07/08/2007
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