Individual
DENNIS W RUNCK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
85 AMBER LILLY DRIVE, BIG SKY, MT 59716-1715
(651) 292-2000
(651) 292-2178
Mailing address
PO BOX 161715, BIG SKY, MT 59716-1715
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
10010
ND
2085R0202X
Diagnostic Radiology Physician
Primary
10839
MT
2085R0202X
Diagnostic Radiology Physician
31004
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
259305000
—
MN
Enumeration date
01/10/2006
Last updated
09/12/2014
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