Organization
FACIAL PLASTIC AND RECONSTRUCTIVE SURGERY MONTANA PC
Active
Other names
Cosmetic Surgical Arts Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RF JOHN HOLTZEN DMD (OWNER)
(406) 549-6600
Entity
Organization
Contact information
Practice address
805 S RESERVE ST, MISSOULA, MT 59801-2104
(406) 549-6600
(406) 549-1511
Mailing address
805 S RESERVE ST, MISSOULA, MT 59801-2104
(406) 549-6600
(406) 549-1511
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
12580
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60882
BLUE CROSS BLUE SHIELD
MT
Enumeration date
05/25/2012
Last updated
04/22/2025
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