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Organization

406 PERIODONTICS, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JESSICA R SWOBODA DDS, MSD (OWNER/MEMBER)
(206) 931-4221
Entity
Organization

Contact information

Practice address
1648 ELLIS ST STE 202, BOZEMAN, MT 59715-8811
(406) 414-1303
(406) 577-2142
Mailing address
1648 ELLIS ST STE 202, BOZEMAN, MT 59715-8811
(206) 931-4221

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary

Other

Enumeration date
08/19/2022
Last updated
08/19/2022
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