Individual
LANI COOK DEIBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
120 N 19TH AVE STE H, BOZEMAN, MT 59718-3920
(406) 585-8701
Mailing address
289 DEREK WAY, BOZEMAN, MT 59718-7304
(406) 570-6913
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
#2271
MT
1223G0001X
General Practice Dentistry
2271
MT
1223G0001X
General Practice Dentistry
D-4032
ID
Other
Enumeration date
11/17/2006
Last updated
11/06/2015
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