Organization
DR. CONNIE SMALL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CONNIE L. SMALL D.D.S (OWNER)
(406) 755-4127
Entity
Organization
Contact information
Practice address
1050 N MERIDIAN RD, KALISPELL, MT 59901-3542
(406) 755-4127
(406) 755-4034
Mailing address
1050 N MERIDIAN RD, KALISPELL, MT 59901-3542
(406) 755-4127
(406) 755-4034
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1758
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164508123
—
MT
05
—
1457323719
—
MT
Enumeration date
12/17/2008
Last updated
12/17/2008
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