Organization
MIHAILOVICH FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COREY A MIHAILOVICH DMD (OWNER/DENTIST)
(406) 494-7033
Entity
Organization
Contact information
Practice address
2423 CORNELL AVE, BUTTE, MT 59701-3848
(406) 494-7033
(406) 494-8256
Mailing address
2423 CORNELL AVE, BUTTE, MT 59701-3848
(406) 494-7033
(406) 494-8256
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5965
MONTANA DENTAL LICENSE NUMBER
MT
Enumeration date
08/07/2019
Last updated
08/07/2019
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