Organization
FULL CARE DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY M LAWHORN D.D.S. (OWNER, DENTIST)
(406) 543-3777
Entity
Organization
Contact information
Practice address
690 SW HIGGINS AVE STE E, MISSOULA, MT 59803-1433
(406) 543-3777
(406) 543-6205
Mailing address
690 SW HIGGINS AVE STE E, MISSOULA, MT 59803-1433
(406) 543-3777
(406) 543-6205
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1744
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0110903
—
MT
01
—
5512828
CHIP
MT
Enumeration date
03/06/2007
Last updated
08/22/2020
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