Individual
DR. MARK COLONNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6516 US HIGHWAY 93 S, WHITEFISH, MT 59937-2916
(406) 862-1010
(406) 863-9090
Mailing address
6516 US HIGHWAY 93 S, WHITEFISH, MT 59937-2916
(406) 862-1010
(406) 863-9090
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1887
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01887-4
BLUECROSS BLUE SHEILD
MT
01
—
5511349
BCBS CHIPS
MT
Enumeration date
05/23/2007
Last updated
07/08/2007
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