Individual
DR. RICHARD FREDERICK JOHN HOLTZEN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
805 S RESERVE ST, MISSOULA, MT 59801-2104
(406) 381-6845
Mailing address
805 S RESERVE ST, MISSOULA, MT 59801-2104
(406) 381-6845
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
101008
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
2431
MT
174400000X
Specialist
Primary
3332-S228
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002202076
—
NV
Enumeration date
06/16/2006
Last updated
11/02/2016
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