Organization
MISSOULA GENERAL DENTISTRY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRI LYNN KINNEE DDS (GENERAL DENTIST)
(406) 541-3585
Entity
Organization
Contact information
Practice address
3020 S RESERVE ST STE B, MISSOULA, MT 59801-7652
(406) 541-3585
Mailing address
3020 S RESERVE ST STE B, MISSOULA, MT 59801-7652
(406) 541-3585
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT2438
STATE OF MONTANA
MT
Enumeration date
06/06/2012
Last updated
06/06/2012
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