Organization
DR. KEVIN PEARSON DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLIE BLACKBURN (ASSITANT)
(406) 587-7200
Entity
Organization
Contact information
Practice address
121 W KAGY BLVD, BOZEMAN, MT 59715-6000
(406) 587-7200
Mailing address
121 W KAGY BLVD, BOZEMAN, MT 59715-6000
(406) 587-7200
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891413167
—
MT
Enumeration date
04/11/2023
Last updated
05/01/2023
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