Individual
DR. SAM R POLLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
15 MONTANA AVE, LAUREL, MT 59044
(406) 628-6716
(406) 628-6373
Mailing address
PO BOX 1025, LAUREL, MT 59044
(406) 628-6716
(406) 628-6373
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2051
MT
1223G0001X
General Practice Dentistry
Primary
2051
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0120105
—
MT
01
—
20514
BLUECROSS
MT
01
—
5512369
CHIP
MT
Enumeration date
10/04/2006
Last updated
11/01/2017
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