Organization
BUTTE SILVER BOW PRIMARY HEALTH CARE CLINIC INC
Active
Parent organization
BUTTE SILVER BOW PRIMARY HEALTH CARE CLINIC, INC.
Other names
Blacktail Dental, Blacktail Health, Blacktail Dental Clinic, Blacktail Medical Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
BUTTE SILVER BOW PRIMARY HEALTH CARE CLINIC, INC.
Authorized official
KAYLA MEDINA (CREDENTIALING COORDINATOR)
(406) 496-6045
Entity
Organization
Contact information
Practice address
125 E GLENDALE ST, DILLON, MT 59725-2505
(406) 683-4440
(406) 683-1121
Mailing address
445 CENTENNIAL AVE, BUTTE, MT 59701-2870
(406) 496-6045
(406) 496-6035
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
MT
261Q00000X
Clinic/Center
—
—
261QD0000X
Dental Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
MT
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0730028
—
MT
01
—
63392
BCBS
MT
01
—
95601016
MT BREAST & CERVICAL PROG
MT
01
—
CK5130
RAILROAD MEDICARE
MT
Enumeration date
09/21/2006
Last updated
02/12/2026
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