Individual
DR. GRANT MATTHEW WISWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, DDS
Contact information
Practice address
3020 S RESERVE ST STE C, MISSOULA, MT 59801-7652
(406) 541-2180
(406) 541-2188
Mailing address
3020 S RESERVE ST STE C, MISSOULA, MT 59801-7652
(406) 541-2180
(406) 541-2188
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2433
MT
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
2433
MT
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
12707
MT
Other
Enumeration date
06/25/2008
Last updated
10/07/2025
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